Blue Jeans Cable International Fax/Mail Order Form

To use this form, please: (1) fill in the information as requested below, and print this form; (2) attach an itemized list of the cables you're ordering (the easiest way to do this is to use our online shopping basket, then print out the contents of the shopping basket window); and (3) fax this form and the list to 1 206 284 2931 or mail to: Blue Jeans Cable, 1419 Elliott Ave W, Suite C, Seattle WA 98119, USA. Shipping is charged in accordance with the shipping table at www.bluejeanscable.co.uk/orderinfo.htm

 
 
Name
Shipping Address
 
 
 
Email Address
Phone Number
Credit Card Info Visa     MasterCard     Discover     AMEX 
Name of Cardholder
Card Number
Expiration Date
V-Code (3 digits, after card number, on back of card (or for AMEX, 4 digits printed on front))
Billing Address
Billing Post Code