Book Order and Credit Card Authorization Form
Fort Stanton Cave Sudy Project; 1 Whispering Winds Trail; Placitas, NM 87043-‐8861; USA
Name of Purchaser:______________________________ Today’s Date:____________
Ship to Address: _______________________________
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Contact Information: E-‐mail ________________________ Phone #: __________________
Check Number: __________________
American Express: _____ Master Card: _____ Visa: _____ Other: ________________
Credit Card #: __________________ Expiration Date: _________ Security Code: ____
Printed Name on Card: ______________ Signature of Card Holder: _________________
Card Billing Address (if different from above): _________________________________
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Quantity of Books Ordered: ___ Est. Shipping: (From Albuquerque, NM USA): __________
Amount Authorized to Charge on Card: $US ________ $AU _________
Order taken by: __________________________________________
Comments: __________________________________________________________
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Note: This form may be scanned and e-‐mailed to [email protected] . We can provide estimated shipping costs via e-‐mail if requested. In the future we expect payment may be made directly on our website as we update our ordering process. Check out [http://FSCSP.org/12-‐MILES/] for additional information.
