ORDER FORM - RETAIL

If you wish to order offline, please fill in the form and fax it or mail it to the address below. If you send it by conventional mail, please use a registered mail or courier AND email us the relevant registration / tracking number, along with the order details: this will ensure a safe delivery and allow us to ship your parcel as soon as we receive the payment. Thank you for your support!

Order details:

Shipping address:

Name: ___________________________    Street Address: ____________________________

City: ____________________________    State/Province: ____________________________

ZIP Code: ________________________    Country: __________________________________

Telephone: _______________________    Email: ____________________________________

Billing address:    Same as above

Name: ___________________________    Street Address: ____________________________

City: ____________________________    State/Province: ____________________________

ZIP Code: ________________________    Country: __________________________________

Telephone: _______________________    Email: ____________________________________

Preferred method of payment:

Cash (enclosed)
Credit card       In this case, please specify the following details as they appear on your card:

First Name: _________________________     Last Name: __________________________

Credit Card Type:  VISA      MasterCard      Discover      American Express      EuroCard

                          JCB        Diner's Club      Optima        Carte Blanche          Carte Bleue

Credit card number: _______________________      Expiration date (MM/YY): _________

Card Verification number (usually a 3-digit number printed on the back): ______________


Please mail or fax to: Underwords - 207-1425 Marine Drive, Vancouver BC - Canada V7T 1B9
Fax +1-604-677-7476


Notes (optional): ___________________________________________________________