Customer Confirmation
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Step 1:
Confirm this sell to information :
Company:(leave blank if N/A)
First Name:
Last Name
Phone
FAX
Addr1
Addr2
City
State
Zip
Country
Email
SIC
Step 2:
Confirm this ship to information
Ship To Company:(leave blank if N/A)
Name
Email
Phone
Fax
Addr1
Addr2
City
State
Zip
Country
PO Number
Need Date
Need Time
All orders are subject to approval by the seller.
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Please select shipping preference to the right.
Shipping and Handling estimated on next page.
Amount
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SalesTax
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Please enter any Special Shipping Instructions/Requests for Delayed Shipping and/or Flavor Assortment Selections
If you'd like a FREE Gift Card Message included with your shipment, please type it here.
Step 3:
Website Builder
Please enter your payment information, or click "next" to view shipping charges, then your browser's "page back" function to complete credit card information and place your order
Credit Card / Check Number:
(example: 11111111111111111)
Expiration Date (mmyy)
(example: 0908 for september 2008
Cardholder's Name:
Enter the name exactly as it appears on the credit card
Zip code:
Must be the zip code of the credit card's billing address
CVV (number of the back)
(example: 0908 for september 2008