Order by Mail/Fax

 

How To Use This Ordering Feature

 

If you prefer to Fax your Order to us with your Credit Card as a Payment method, Please Fill the Below Form and Fax it to:  

 

(713) 782-2763        Security Measure: All Faxes Upon Order Fulfillment are Shredded!

 

If you prefer to Order by Mail and Pay By Money Order/Cashiers Check/ Personal Check / Business Check, Please Print and Fill in the Below Form and Mail it with your Payment to:

 

WirelessGalaxy Houston

Mail Orders Dept.

8342 Rustling Leaves Dr

Houston, TX 77083, USA

 

Call us at # 281-530-9101

 

 

WirelessGalaxy Houston Fast Mail/Fax Order Form

 

Item/Kit Name and Description if available	Phone Model	Advertised Sale Price	Quantity	Total
Shipping & Handling Charges	FREE	FREE	FREE	$0.00 FREE
Total	-	-	-

 

 

Select Payment Method:

 

Check Appropriate Box R

 

       Pay By Credit Card:

 

Credit Card Account Number: ______________________________

 

Credit Card Expiration Date:   _____/ ____

                                                      (MM / YY)



        Money Order/Cashiers Check/ Personal Check / Business Check (Enclose the Payment and Mail to Our Address Given at the Top of this Form)

 

Mail My Order to the Following Address:

 

Attention To:

 

Full Name:             ____________________________________________________________

 

Email:                     ____________________________________________________________

 

Address:                _______________________________________________________________________

 

City:                        ____________________________________________________________

 

State:                      ____________________________

 

ZipCode:                ____________________________

 

Country:                ____________________________

 

Work Phone Number: (      ) _____________________

 

Home Phone Number: (      ) _____________________

 

 

 

? Need Help Filling this Form, Please Call 281-530-9101

 

Security Measure: All Faxes Upon Order Fulfillment are Shredded!

 

 

Document No: WGSK07082002

Copyright WirelessGalaxy Houston