Shopcig.com
Please Send the following item(s):
| ____________________________________________________ | $ _______ | ||||
| ____________________________________________________ | $ _______ | ||||
| ____________________________________________________ | $ _______ | ||||
| ____________________________________________________ | $ _______ | ||||
| Total | $ _______ | ||||
I agree to pay the above amount
__________ Date:__________
Name ___________________________________________________________
Business _________________________________________________________
Address _________________________________________________________
City
__________________________________ State ________ Zip __________
Country _________________________
Phone (Required)_____________________________________
Fax ______________________________________ Email: _________________
Payment By: ( ) Visa ( ) MasterCard ( ) American Express ( ) Diners Club
Card Number: ______________________________Exp Date: ______________
Verification Number (Click here for details) ______________
Ship to: (If different from above)
Name __________________________________________________________
Address ________________________________________________________
City ____________________________
State ________ Zip _______________
Country _________________________
Phone __________________________
Shipping Instructions:
When orders are received we guarantee to send them in 2 working days (usually
it takes not much than 36 hours). Orders received on Saturdays are sent on the
first working day following reception (Sundays and public holidays). The day
and time when your order was packed and shipped you'll receive in the special
e-mail.
Attention! Orders without working e-mail may not be sent!
Print and FAX this form to Shopcig.com +1 (310) 388-1407