INFORMATION NEEDED TO FAX YOUR ORDER TO 212-807-7993

Your Name:
Company:
Address:
Telephone:
Fax:
Email address if you wish to be contacted by this method:

Please write your orders by date wanted and by item!
Putting what you want by the date to be shipped is the most important.

Here's what we need:

Desired Shipment Date
Quantity
Item Wanted
Ship To:
Name:
Address:
Telephone:

Shipment method: US Priority Mail ( )
Federal Express ( ) must have phone #

Message on card: (be brief)

Credit Card:
Expiration:
If you prefer, you may call us with your card information. 1-888-419-4824

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