I have read, understood and accepted the Terms and Conditions and I wish to
order the following items: 
Please print it out. Type or print clearly. Mail or Fax to: 

IMPORTANT: incompletely filled out orders will be delayed (not processed).


Code#   Country     Description           Grade    Unit Price   Qty      Total
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NOTE: Attach your order on a separate sheet if necessary. Sign every sheet.
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                                                       SUBTOTAL: _____________

            South Carolina Residents - Your County: __________________________

            South Carolina Residents Pay State/County Sales Tax: ____    %____

         POSTAGE & HANDLING(delivery by_____________________mail): ___________

Your UPS Account # (if you pay your own shipping):____________________________

Your FedEx Account # (if you pay your own shipping):__________________________

                                                          TOTAL: _____________


I am paying with/via: (  ) PAYPAL**  (  ) CHECK  (  ) MONEY ORDER  (  ) CASH
(  ) BANK WIRE TRANSFER  (  ) BANK DRAFT  (  ) WESTERN UNION  (  ) MONEYGRAM
(  ) OTHER _________________________________________________________________

** Please send your PAYPAL payment to:  

Your Paypal email address: ___________________________________________________

Or please debit my credit/debit card  for my order:

(  ) VISA  (  ) MC  (  ) AMEX  (  ) DISCOVER  (  ) NOVUS

Name on Credit/Debit Card: ___________________________________________________

Billing Company (if any): ____________________________________________________

Card Number*: [______________________________________________________________]

* American Express # is 15 digit, Visa 13 or 16 digit, MC & Discover 16 digit.

CVV/CVC/CIN # (3/4 digits on the back/front of your card): [_________________]

Customer Accounting Code (if corporate card): ________________________________

Card Expiration Date: [______/___________] (MM/YYYY)


Billing/Statement Address: ___________________________________________________

City: ________________________________ Province/State: _______________________

Postal Code/Zip: _____________________ Country: ______________________________

DATE OF ORDER ____________________

PERSONAL/BUSINESS/SHIPPING INFORMATION (please type or print clearly)

Name: (Mr./Ms.)_______________________________________________________________

Business Name (if any): ______________________________________________________

Shipping Address: ____________________________________________________________

City: _______________________________ Province/State: ________________________

Postal Code/Zip: ____________________ Country: _______________________________

(   ) Check if the above address is a commercial location (for UPS and FEDEX)
(   ) Check if the above is a residential address (for UPS and FEDEX shipping)
(   ) Check if the above address is a home-based business (for UPS and FEDEX)

NOTE: please check only one selection above!

Phone number: (     )_________________________________

Fax number: (     )___________________________________

E-mail(print it clearly): ____________________________________________________

Comments: ____________________________________________________________________

______________________________________________________________________________


Authorisation Signature: _____________________________________________________