Planet CD-ROM Credit Card FAX Order
Please print all information clearly so we can process your order correctly and quickly.
Payments are in U.S. funds only. Fax the completed form to: 1-888-484-7373 or 1-650-872-7135

1. Your name ______________________________________________________

and Email Address
    ________________________________________________
(this enables us to locate your customer account and send email on your order's status)

2. Telephone Number: ___________________________________
(Only used if we need to contact you directly about the order.)

3. Billing Address

 

4. Shipping Address  U.S. Address ONLY!

 

(please specify apartments, suite numbers, etc.)

5.
Product Code
(Example: pc12345)
Product Name & Description How Many S&D
Each
Subtotal
         
         
         
         
         
 
Total
 

Thank you for your order! If you have questions, please contact us at Customer Service. We will send a confirmation email when your order is processed and shipped. Please allow 10-14 business days for U.S. orders. (Note: We currently do not accept any international orders).
Please FAX your credit card order to: 1-805-226-5238

Credit Card # ________________________________________ ( Visa / MC / Disc )
CSV Code: __________
(CSV is a 3 digit code on back of card for VISA/MC, none for Discover. We Don't accept AMEX.)

Exp Date: ______/___________ (MM/YYYY)

Name on Card: ___________________________________________