Order Form First Name Last Name Street Address (shipping address) City State Zip Code Email Address Phone Preferred Method of Contact Preferred Method of Contact Email Phone I am 18 years or older or have my parents permission I am 18 years or older or have my parents permission Yes No Order Details (ID# / Price) Shipping Total Preferred Arrival Date (mm/dd) Shipping is $45 in California, $50 in U.S., International please inquire. We typically ship Monday, Tuesday, and Wednesday each week for arrival the next day. Arrival is possible on Friday or Saturday, but we may waive our live arrival guarantee. Saturday delivery costs an additional $15. Contact us for more info. Shipping is $45 in California, $50 in U.S., International please inquire. We typically ship Monday, Tuesday, and Wednesday each week for arrival the next day. Arrival is possible on Friday or Saturday, but we may waive our live arrival guarantee. Saturday delivery costs an additional $15. Contact us for more info. Order Total (CA residents add 7.25% sales tax) Payment Method Payment Method Credit Card PayPal Money Order Check Wire Transfer *If paying by credit card, please enter your details below. * Your card will NOT be charged immediately when you submit this form. We will confirm the order when it is received. *Our online order form is secure, your information will not be shared. *If paying by Paypal, our account is steve@geckosetc.com. *If paying by credit card, please enter your details below. * Your card will NOT be charged immediately when you submit this form. We will confirm the order when it is received. *Our online order form is secure, your information will not be shared. *If paying by Paypal, our account is steve@geckosetc.com. Is your credit card billing address the same as your shipping address? Is your credit card billing address the same as your shipping address? Yes No - Please enter your billing address below Not Applicable Street City State Zip Code Name on Card Card Type Card Type Visa Master Card Discover Card Number Expiration Date (mm/yy) CVV Code on back of card Any additional notes or information 10 + 1 = Submit after completing security question
