Fax Order Form

Customer Service 1-877-422-2954 1-877-4babykick Fax 1-866-381-7208

Name:		Name:
Billing Address:		Shipping Address:
Phone (day):		Phone (day):
Phone (eve):
Email Address:

Payment Method
If paying by credit card, please select a payment method and Fax to us at 1-866-381-7208

____ Visa     ____ MastarCard     ____ American Express     ____ Discover     ____ JCB    

Name of Card:
Credit Card Number:		3-digit code:
Expiration Date:

If paying by Cashier’s Check or Money Order (No personal check accepted), please make payment payable to: VoiKex

Mail Payment to:
   VoiKex
   P.O. Box 1568
   Manhattan Beach, CA 90267

Item Description	Size	Price	Quantity	Total
			Subtotal
			Shipping
			Tax(if applicable)
			Total

*Please include Sales Tax of 7.75% if shipping within California.

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