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										Payment Information:
								 
								Visa 
									
									Mastercard 
									
									American Express 
								 
									
										Acct. Number: 
									
									
									Expiration Date: 
									
									
										(mm/yyyy)
 Name on Card:
 
									
										DELIVERY TIMES MAY VARY, ESPECIALLY ON FOREIGN SHIPMENTS:
									PLEASE ALLOW 3 - 6 WEEKS FOR DELIVERY
 
									
										PLEASE NOTE: YOUR CHARGE WILL SHOW UP AS "LIGHTHOUSE MARKETING"
									
									Your Credit Card will not be charged until your order is shipped
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