MCity1.com
Please Send the following item(s):
| ____________________________________________________ | $ _______ | ||||
| ______________________________________________________ | $ _______ | ||||
| ______________________________________________________ | $ _______ | ||||
| ______________________________________________________ | $ _______ | ||||
| Total | $ _______ | ||||
I agree to pay the above amount
__________ Date:__________
Name ______________________________________________________
Business ______________________________________________________
Address ____________________________________________________
City __________________________________ State ________ Zip ______________
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 ______________
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 MCity1.com +1 (310) 388-1407