Blue Jeans Cable Fax/Mail Order Form

To use this form, please: (1) fill in the information as requested below, and print this form; (2) attach an itemized list of the cables you're ordering (the easiest way to do this is to use our online shopping cart, then print out the contents of the shopping cart window); and (3) fax this form and the list to (206) 284-2931 or mail to: Blue Jeans Cable 3216 16th Ave W, Seattle WA 98119. Shipping is charged in accordance with our standard shipping rates (viewable by using our online shopping cart and proceeding as though to check out).

 
 
Name
Shipping Address
 
 
 
Email Address
Phone Number
Credit Card Info Visa     MasterCard     Discover 
Name of Cardholder
Card Number
Expiration Date
V-Code (3 digits, after card number, on back of card)
Billing Address
Billing Zip Code
Shipping Method:

Priority Mail     FedEx Overnight     FedEx 2nd Day  Other:___________________________________________
NOTE: Our ability to ship immediately by FedEx may be limited depending on workload. If time of arrival is critical, please call us to confirm we'll be able to accommodate you.