|Fax your order to 1-248-304-9910
P.O. Box 300351
Waterford, Michigan 48330
Unable to call us during normal working hours? Fill in the following information and fax us this form. We will process your order within 48 hours or two working days and have "BUGEYES to your door within 10 days!*
- I live in the United States and want to order ________ (number of "Bugeyes") @ $19.95 each plus $3.00 each ($4.00 for a pair) for shipping and handling (Michigan residents add 6% sales tax).
- I live in Canada and I want to order__________(number of "Bugeyes") @ $19.95 each (US Dollars USD) plus $4.00 ($5.00 for a pair) USD each for shipping and handling (GST and other import taxes are purchaser responsibility.
- I live outside the US and Canada and want to order________(number of "Bugeyes") @ $19.95 each USD and will accept the necessary shipping charges for best method shipping.
Card Members first name, middle initial, and last name_______________________________________
- Charge my VISA or MasterCard. My account information is as follows:
Card Number: _ _ _ _- _ _ _ _- _ _ _ _- _ _ _ _ Expiration date: _ _ /_ _
Please ship my "BUGEYES" to:
Street and Apt. number: _____________________________________
City:______________________________ State: _________________ Zip:______________________
*This form is for US and Canadian orders only!