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Gemini Publishing Co. Secure Order Form
Warning: When entering data in this form please do not use the Enter key on your keyboard. Use your mouse & cursor to enter data.
Important: Enter a valid e-mail address. Receipts will be sent to this address.
E-Mail:*
Enter Item# with Description, Price and Quantity
Item 1:*
Item 2:
Item 3:
Item 4:
Item 5:
Item 6:
Item 7:
Item 8:
Sub-Total:
Tax (TX 6.50%):
Shipping for U.S. Orders
Shipping for Canadian Orders:
Shipping for Foreign Orders:
Grand Total:
*Quantity discounts will be deducted from your total when credit card is charged
Billing Information
First Name*
Middle Initial:
Last Name:*
Address Line 1:*Where your statement is mailed
Address Line 2:Apt. or Suite No.
City:*
State:
Country*
Zip Code/Postal Code:*
Phone:
Shipping Information
Same as billing info:*
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First Name:*
Middle Initial:
Last Name:*
Address Line 1:*
Address Line 2:
City:*
State:
Country*
Zip Code/Postal Code:*
Payment Information
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Credit Card 
Card Number:*No dashes or spaces please
Expiration Month:*From your card
Expiration Year:*From your card
Card Brand:*
Comments:
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Gemini Publishing Co., PO Box 57931, Webster, TX 77598, 832-224-4195, Website: www.getgirls.com, email: getgirls@getgirls.com
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