Print This Page Out and Fax To:

(563) 332-1947 John Wells PO Box 1733 Bettendorf, IA 52722

for credit card sales

PLEASE EMAIL ME WHEN ORDERING WITH CREDIT CARD

WE Accept VISA And MASTERCARD ONLY

Postage and Handling-FREE within the United States

Your Name as it appears on the credit card

_________________________________________

Credit Card Number___________________________________________

VISA or MASTERCARD Please circle one

Expiration Date_________________

Billing Address______________________________________________

Billing City/State/Zip___________________________________________

Email/Phone Number________________________________________

Shipping Address___________________________________________

Shipping City/State/Zip Code____________________________________

I hereby authorize John Wells to charge my credit card $____________

Signature________________________________________________

Email for information on foreign countries.

THIS IS IMPORTANT------My name-John Wells is what will appear on your billing statement.....so do not forget that John Wells will appear on your billing statement.

How did you find the Cool Stuff website?

Advertisement, link, post on newsgroup, word of mouth, comic/toy show, other____________

Be sure to check the bottom of each page of my site for additional ordering info