Credit Card Payment Form Most of my merchandise is one-of-a-kind, individually hand made and available for a limited time. I do not have a warehouse stocked with boxes of merchandise! Some items, such as Bawdy Dusters and items in the “Currently Available” sections may be ordered and shipped within two weeks. Items that must be constructed upon order or are being made-to-order will take longer. I accept orders by phone, mail or email. Orders can be placed and payment may be mailed in the form of a check, Money Order or you may use the credit card payment form and fax it to 323.372.1630. Please allow 2 weeks processing for personal checks. I do not ship C.O.D. Please fill out this form, print the form, SIGN the form and mail or fax it to us! *** NO INFORMATION WILL BE TRANSMITTED OR STORED -- THIS IS A PRINTABLE FORM ONLY
Name: Address: City: State: Zip: Phone: email:
Item(s) Purchased: Type description here Price with tax: Shipping: TOTAL:
CREDIT CARD INFORMATION: Card Type: Master Card Visa ******* Name on Card: Billing Address: Same as Mailing Address Other: Address: City: State: Zip:
Card Number: Expiration Date: Validation Code (3 digit found on back of card): I agree that I am the owner of the credit card above and that the above charges are to be charged to that card. SIGNATURE (Required): X_____________________________________________ Form must be complete on ONE page. Reset resolution to fit.
MAILTO: Whimseywear****5407 E. Willow Street****Long Beach, CA 90815****PH 562.421.4391
OR FAX COMPLETE FORM TO: 323.372.1630 Artist@whimseywear.com