Special Order Form

Please note:

This order form is only for special orders that have been pre-arranged, via telephone, with the management team at Please provide a comprehensive description of your order, as well as the agreed-to price. The next step will advance you directly to our online payment processing system. Thank you.

Full Description of Your Order *

Amount of Payment


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Shipping Information

Recipient's Name First:    Last:
City, State, Postal Code    
Email Address

Billing Information

Credit Card
Card Number
Expiration Date
Cardholder's Name First Name
Last Name
Billing Address
City, State, Postal Code    

Payment Gateway

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