| Name: | |
| Billing Address: |
| City: | State/Province: |
| Zip Code/Country: |
| Email address: |
Credit Card # __________________________ Phone # (Back of card)
Expiration
Date: _________________CVV#
____________
(3 Digit # on back of card, 4 Digit # on front of American Express)
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Item Number |
Size |
Quantity |
Description |
Price |
By signing this agreement you authorize JMJ Ventures, Inc (AttitudeTees.com/JMJ Ventures Inc) to charge your credit card in the above amount and agree to all terms and conditions for credit card authorization and sales. You agree not to charge back to the above merchant for this sale. You also agree to the terms and conditions stated on the page when you click on "shipping info" which can be found on the top of all main pages of our website AttitudeTees.com.
I Authorize JMJ Ventures, Inc (d/b/a AttitudeTees.com) to charge my credit card in the amount of:
$
Customer Signature: __________________________________________
Date:
FAX NUMBER: 414-483-1930
THANK YOU.