hkDVDstore.com - Mail/Fax Order Form

hkDVDstore.com - Mail/Fax Order Form hkDVDstore.com Mail/Fax Order Form Optional form for customers who wish to fax their order to us. Otherwise, please complete an order via the website. Thanks!

Please Make Sure All Fields Are Filled In. Print and Fax All Orders To:

NAME
STREET ADDRESS (INCLUDE APT/SUITE)
CITY, STATE, ZIP CODE
TELEPHONE
EMAIL ADDRESS

TITLE PRODUCT ID PRICE QUANTITY

- Use Another Sheet If Ordering More Than 10 Titles.

[ ] INSURE PACKAGE ($+1.25) | [ ] SIGNATURE DELIVERY ON PACKAGE (+$1.50)
* APPROPRIATE S&H FEE RANGING FROM $2.50 TO $6 (DEPENDING ON THE NUMBER OF TITLES ORDERED) WILL BE ADDED TO YOUR ORDER. PLEASE REVIEW THE S&H RATES ON OUR WEBSITE FOR MORE INFO.

*** CREDIT CARD AUTHORIZATION FOR ORDER CHARGE

CREDIT CARD NUMBER
EXPIRATION DATE
CVV2 (LAST 3 OR 4 DIGIT AFTER ACTUAL CARD NUMBER)
SIGNATURE (AUTHORIZING ORDER CHARGE)
PRINT NAME / DATE

ALTERNATE SHIPTO/ADDRESS

NAME
STREET ADDRESS (INCLUDE APT/SUITE)
CITY, STATE, ZIP CODE