WMJ Marine - Order Form

 Shipping Address  Billing Address (If different from Shipping Address)
Name: Name:
Street Address: Street Address:
City, State, Zip code: City, State, Zip code:
Country: Country:
Phone: Phone:
Fax: Fax:
E-mail: E-mail:

It is so easy to order with any of these options:

Sales Tax for items sold in California

Payment Method:                         __Check Enclosed     __Credit Card     __ Bank Wire Transfer    __ Money Order

Credit Card Order
:                   
__Visa     __Master     __Discover    __American Express

Number  
Expiration Date  
Cardholder Name  
Security Code *  

* Last Three Number on the BACK of your credit card around the signature panel

Shipping Method  within United States
 :    
__ UPS Ground      __ UPS 3 Day Select    __ UPS 2nd Day Air    __ UPS Next Day Air   __ US Postal Priority Mail 

                                                                             __  US Postal Express

International Shipping:          __ UPS Worldwide Expedited     __ UPS Worldwide Express     __ US Postal Global Express   __ UPS International Ground (Canada) 

                                                    __ Fed Ex International
 

Catalog Item # Description Quantity Unit Price Total Price
         
         
         
         

We will confirm your order with the total charge including shipping charge or applicable tax via email.  Thank you for shopping with WMJ Marine.

___________________________________  Signature                  ____________________  Date