Please take a print and complete the following information and FAX / Mail to:
East West International
5810 Hillcroft Ave. Houston, TX 77036
FAX No. - 713-789-6662

Name(As appears on the Credit Card)_______________________________________________________________

Telephone No. - Office:__________________ Home:______________________ Cell:_______________________

Card Type: Visa:______ MasterCard:______ Discover:______ American Express:______

Card No.:__________________________________________ Expiration Date:_________________

3 Digit CVV Code on back of the Credit Card:__________

Credit Card Issuer(Bank) Name & Phone no. ____________________________________________________________

I, ________________________________________________, authorize East West International to charge my credit card
for the purchase of the item(s) listed below.

Billing Address: ______________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

Shipping Address: ___________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

TERMS AND CONDITIONS:

• Once Shipped orders cannot be cancelled. All sales final.
• No exchanges, no refunds.
• Merchandise warranted by manufactures only. (If applicable). Defective merchandise must
  be exchanged within three days only.
• Prices cannot be adjusted once the order has been made.
  

Sign here to confirm order _______________________________ Date: ________________________