• All blocks on this form marked ( * ) must be
completed or your payment cannot be processed.
• Your "Bill To" address must
be the same address to which your credit card statement is sent. For YOUR
protection, credit card companies require address verification for internet
orders. However, if you want your parcel sent to other than your credit card
address please complete all the blocks in the "Ship To" column. A street address
is required for shipping.
• There are 2 blocks for your address in case you
want to include a company name or if you have the type of address that requires
• A space is provided for YOUR ORDER. In this space tell us
precisely what you want; details such as, product code [if there is one],
manufacturer's name, product type, scent, size, price and quantity. All other
comments should be sent via email to firstname.lastname@example.org.