| Bill To: | Ship To: | |
| Email Address*: | ||
| First Name*: | ||
| Last Name*: | ||
| Company: | ||
| Address Line 1*: | ||
| Address Line 2: | ||
| City*: | ||
| State*: | ||
| Zip*: | ||
| Daytime Phone*: | ||
| Cell Phone: | ||
| Fax Number: |
| U.S.P.S.Priority Mail | $10.50 | ||
| 2nd Day Delivery (2 Business Days)excludes Saturday delivery add $16.99 per line item to base rate |
$58.97 |
| Future Shipping Date : | (This is Not the Delivery Date) |
| Using the following credit card: Type of Card: Card Number: Expiration Date: |
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For your protection, please verify your credit card information by entering the card identification number. |
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1- MasterCard, Visa or Discover Cards The card identification number is the last 3 digits of the number located on the back of your card next to your signature. 2- American Express Cards The card identification number is the last 4 digits of the number located on the front right of your card above the credit card number |
| I would prefer to provide my credit card information over the phone. Please call Specialty fruit clubs.com at 714-656-4148 after you have submitted your order. |
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| PLEASE NOTE: For pay-by-phone and pay-by-fax orders, you will be reminded to send your payment information at the end of this checkout. Your order can NOT be processed until payment is received. |
Your Signature To Day's Date