Note: If you choose to pay by credit card, you
will be contacted by telephone by a representative of Friends Caring and
Sharing or of The CARING Place, to confirm details of your order and to
request your credit card number. We do not like to rely on internet security
for transactions of this nature.
If you would prefer not to give out credit card information over the telephone, please feel free to print off this form, complete it and the credit card information listed below, and fax it to Friends Caring and Sharing at 519-338-3360.
Additional Information Required for Payment by Credit Card (Fax Option):
VISA Credit Card Number ______________________________ Visa Cards (only) accepted at the present time
Name as it appears on card ____________________________________
Expiry Date __________________________
Signature of Cardholder ________________________________________
Please allow four weeks for delivery (six weeks if paying by cheque).