SpellSpot Credit Card Order Form

We DO NOT ACCEPT this form of payment for orders outside of the Continental USA

 

Mail this form to us at: Carey Enterprises, P.O. Box 2861, Orange, CA 92859-2861

You will receive a confirmation of receipt via email within 24 hours.
Customer Information
First Name*       
Last Name *       
Email      
Phone      
*Name must match information on credit card exactly
Credit Card Information
Card Type      
Card Number      
Expiration Date      

Card Verification Number (info see: http://www.dilos.com/ccv.html)

    
Shipping Address:
Address      
City      
State      
Zip Code      
Country      
Billing Address*:
*Must match credit card statement. Do not complete if same as Shipping Address
Address      
City      
State      
Zip Code      
Country      
Item(s) Ordered :   Price:
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
*Shipping Based on Order Total Total:   
$0.00 - $50.00 = $7.00  Shipping*  
$51.00 - $80.00 = $9.00 Grand Total:  
$81.00 - $100.00 = $12.00 
$101.00 - $300.00 = $13.00 
over $301.00 = $14.00 
Thank You for your order and Blessed Be!
~ SpellSpot.com