Billing/Shipping and Payment Information
| Name |
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| Address |
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| City |
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| State |
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| Zip |
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| Country |
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| Phone |
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| E-Mail |
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| Check? |
I am enclosing a check for payment |
| Credit Card Type |
Visa
MasterCard
Discover
American Express |
| Credit Card # |
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| V-Code (# on back of card) |
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| Card Expiration |
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| Credit Card Holder |
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| Credit Card Signature |
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Mail to:
Joslin Photo Puzzle Co.
302 Bel Air Road
Southampton, PA 18966-3322 USA
Be sure to include the following:
This completed order form
Your check or credit card info
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