This order information is being sent on a secure link to Weird Science. To place orders via an unsecure web page please ensure you select 'Order Secure' button on the 'Ordering' page or 'Click Here' to jump straight to the Unsecure Orders page. Secure orders require a web browser capable of SSL Transactions.

To complete your order just fill in the form below and hit the 'Place Order' button. Please ensure you complete the 'Email Address' field in case we have any problems with your order.

order-secure.gif (11928 bytes)

Trade Order Details

Company Name:
Telephone Number:
Fax Number:
E-Mail Address:

Credit Card Type:
Credit Card Number:
Credit Card Expiration Date: Issue No.:
Credit Card Holder's Name:


Please press the 'Place Order' button only ONCE.

<%%>