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ONLINE ORDER FORM / AUCTION PAYMENT FORM: Fill out the form COMPLETELY with ALL your Information & ITEM SELECTION OR Ebay Auction Information and punch Send You will receive an email confirmation From Me when Information is received! Your card will not be charged until items are shipped! This form is secured by H-Forms.com Mark your Selection, Quantity, & Price! Click Send, we'll do the rest! (Items shipped within 3-10 days Depending Upon Availability!) ************************* I accept Money Orders..  (SCNOP, PO BOX 252, PALMYRA, NY14522) Just fill in the information COMPLETELY & indicate you will be paying  by money order, CREDIT CARD (Visa, Master Card, or Discover - Sorry NO AMEX) or by PayPal where indicated below.& Click send!   ********* For Western / UpstateNY Customers.. Place your order online  and you can pick up your purchase at our  Retail Location in Newark, NY If you are concerned about transmitting your Credit Card Info - Please Fill out the form and send it - But Call Me Directly to provide the Card Information - (315) 597 - 5330 or FAX ME: (315) 597 - 6892     Thanks for visiting my site! Your Order is much appreciated! Just complete this form. Click on Submit when ready to send.   Your name: Email address: Required ORDER NUMBER = TO CONFIRM -- PLEASE Reenter your Order Number ABOVE INTO BOX below? Order Number?   REQUEST FORM  How Many? PLEASE BE SURE TO GIVE ME YOUR EMAIL ADDRESS SO THAT I MAY CONTACT YOU! Make sure you Enter it in the Box where indicated! E-mail address? ****************** _________________ Your name? Street Address? City? State? Zip? Country? Phone? Ebay Auction number?   ___________________________ Item1 number & Name? Quantity1? Price1? Item2 number & Name? Quantity2? Price2? Item3 number & Name? Quantity3? Price3? _________________________________________________ Need Gift Wrapping? I will Gift wrap your item for 2.99 each! Just Tell Me HOW MANY? & & for WHAT Occasion? Requesting Gift Wrapping? Quantity? Occasion? Message? For Gift Wrap Details? _________________________________________________ Club Card Discount Program? We have 2 Membership levels.  Annually for     Life Time for Your Membership Enrollment entitles you to  10% off all your Sexybloomers.com purchases! If you enroll - your first Time purchases will receive discount! Requesting Annual Membership - 20.00? Requesting Life Time Membership - 75.00? You Password? That you have selected for your account? A club card will be sent with your purchase! All club cards are dated and valid for Your Membership Level. Club Card Memberships can not be refunded or rescinded once activated. All special discount programs may not be combined with Club card.  The Club card replaces all early order discount and garden club discount programs.   Club card is valid towards all products listed by Sexybloomers.com including patio lights, gazing balls, wine bags and catnip products. Club Card is not valid toward any Bench Racing Nascar Diecast Racing Collectables. Club CARD is not valid toward Ebay or other auction programs. Club card discount is not applicable toward shipping or handling. ******************************************** WILL PICK UP MY ITEM AT NEWARK, NY STORE? ****************************************** INTERNATIONAL SHIPPING - We'll Email you back with best price! COUNTRY? Requesting 4-7 DAYS? Requesting 4-7 WEEKS? Requesting GLOBAL PRIORITY? Requesting GLOBAL EMS? ***************************************** I AM Requesting Insurance upto 50.00? Apply Gift Certificate? Club Card ID? HANDLING FOR MY ORDER - ADD 3.99 USD ON REGULAR (NON EBAY MERCHANDISE) OR 5.99 USD ON AIRBLOWNS? SubTotal? Shipping? Grand Total? __________________________ HOW DO YOU WISH TO PAY? Sending Money Order? I PREFER PAYPAL - MY PayPal Id and Email address IS?? PayPal Email ID? PLEASE INVOICE MY PayPal ACCOUNT? ****  *****  **** I'D RATHER USE MY CREDIT CARD via Visa, Master Card or Discover ( sorry no amex) - fill information BELOW! THIS FORM IS SECURED VIA H.FORMS.COM IT WILL ACCEPT YOUR CREDIT CARD NUMBER. All credit card orders must pass AVS verified.  Be Sure your address is correct! PLEASE PUT YOUR CC# IN THE BOX BELOW - Just put your number in behind the letters in the box! Thank You! YOUR CARD NUMBER? Expiration number? Enter 3 cvc code after letters  in box?   YOUR 3 DIGIT CVC CODE ON THE BACK OF YOUR CARD IS REQUIRED. You may enter it or I WILL TELEPHONE / OR EMAIL YOU FOR THE CODE TO VERIFY THE TRANSACTION. ____________________________________________________ E-mail address? FEDEX Ground Number? UPS Number? Requesting Express Overnight Mail? Comments? Shipping Instructions? Comments? Our Shopping cart will securely accept any major credit card, Money Order as well as PayPal! **** **** ****  SEE OUR RACE CAR!  OUR TEAM!!     Are you a REAL Race Fan?? IT IS RACE SEASON.. WE ARE ACCEPTING .00 DONATIONS TO THE TEAM. #77 DIRT! DINO! ***SEE DINO? COME RACE!   _______________________________________ My E-mail scnop / cator enterprises Sexybloomers Inc. po box 252 4496 South Creek Road Palmrya, NY 14522 work: (315) 597-5330 fax: (315) 597-6892 scnop9@icqmail.com