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Alan's Custom Lab
Credit Card Payment 

Credit Card Type (Check One)

Visa______    MasterCard______   American Express______    Discover Card______

Name of Cardholder_______________________________________________________

Card Number _____________________________________________________________

Expiration Date____________________________________________________________

Signature _________________________________________________________________

Shipping Information

Shipping and handling charges are in addition to your order.  There will be a handling charge of $5.00 for orders 8x10 size and under and $7.00 for orders over 8x10 size. Typical shipping charges will be from $10.00 to $25.00 depending on carrier and how fast it is shipped.

Name____________________________________________________________________

Shipping Address__________________________________________________________

City ______________________________________________________________________

State_______________________________________________ Zip___________________

Area Code & Phone________________________________________________________

How do you want your order shipped? (Check one)
     Alan's will charge your credit card or carrier id will be placed on the shipping order.

FedEx______     UPS______     Priority Mail ______     Airborne Express______

Overnight______     Next Day_______     1 Day______     2 Day______     3 Day______

Do you have a carrier number?  Yes______     No______
If so, tell us the carrier and number here

                        CARRIER____________________________________________________

 ID Number__________________________________________________

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