QuickBurst MAIL ORDER FORM:
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If you are a Texas Resident or shipping to a Texas address, add Sales Tax at .0825% |
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Please Make Checks or Money
Orders payable to: QuickBurst
Complete form and mail to:
QuickBurst
Your Name:
________________________________________
Today’s Date: _______________________________________
Your E-Mail Address: ________________________________________
We do not share your e-mail
address with anybody, ever.
Credit Card Form:
Your Name as it appears on
card: _______________________________
Type of card: _____________________
We accept,
Master Card, Visa and Discover Only.
Account #: __________ / __________ / __________ /
__________
Expiration Date: _______ /
_______
V-Code: ___________________________ .
Note:
This is the three digit number found in the signature panel on the back of
the card or near the embossed account number on the front. We can not process
your card without it.
Shipping Address:
Name: ________________________________________
Street: _______________________________
City: __________________________
State/Zip: __________ , /
_______________
Billing Info: If different from above.
Name: ________________________________________
Street: _______________________________
City: __________________________
State/Zip: __________ , ________________
Charges to your credit card
will appear as QuickBurst.