SECURED ORDER PAGE
DUE TO SYSTEM UPDATE YOU CANNOT PLACE YOUR ORDER USING THIS PAGE, BUT YOU NEED TO CLICK HERE TO CONTACT US
Place your Order here To Receive The Free Shipping.
This secured order page guarantees that your personal information will be safeguarded.
Do you want the Expedited
Processing for $39.50?
If you want us to reserve our today's low price for you,
and want us to charge your account and ship this product at a later time in
the future, please take a note:
Information about You as the
Purchaser (shipping address may be different if wanted as shown on the next page)
Telephone with area code
(must have to receive confirmation)
(leave blank if the same as the
Telephone with area code email
choose one below
One: pay by check electronically
Click here why!
Routing umber: (must be 9 digits)
Confirm Account number:
Check number: (upper right corner)
Option Two: fax us your order:
1. Fill out the order form above
2. Print out this form
3. Fax it to us at 203-741-1040 (24/7, anytime)
Option Three: send your physical check or money order to
(CLICK the Submit button, then please wait a few seconds
for the page to upload)