Beautiful Naturally Wigs Hairpieces Credit Card Payment Form
See the mail in order Form. Mail Order Form
Go Back To OR READ The Information on How To Fill In Order Form
This page consists of the information needed from you in order for you to send
a mailed in payment with a charge card.
Print out Page One, fill in the spaces and enclose this page with your
filled in Mail Order Form purchase information when you are paying with a charge card.
Or write this information on a regular piece of paper.
Circle Type of Credit Card __Visa__ Master Card__ Discover__ American Express.
Please! No Charge Card is to be used for purchases less than $30.00. (send a check)
Card Number________________________________ Exp. Date________
Credit Card Security Numbers:
Last Three Digits or Numbers on back of the card______ American Express Four Numbers______
Charge Card holder's name. Mailing Address for Credit Card Statement
Name____________________________
Address_____________________________________________________________________________
Zip Code_________
Phone Day and Evening _____________________________________________________________
If shipping to another address, please specify on top of the order form.
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