Southern Cricket Wholesale, Inc. Order Form
(This is a secure form, your cc numbers can't be seen by anyone but Southern Cricket)
"Notice: Crickets must be delivered to a location where someone will be present.
Southern Cricket will not be responsible for crickets left outside in the cold."  
Minimum order amount $7.25 before freight

	YOUR BILLING INFORMATION : * Required Fields
*Name
Business Name
*Street Address
Address (cont.)
*City
*State/Province
*Zip/Postal Code
Country
*Daytime Phone
Evening Phone
*E-mail

 

	PAYMENT INFORMATION
Payment Method	- Payment Type - VISA Master Card Discover Card Amex Preapproved Credit Other
CC Number
CC Expiration Date MM/YY

Please call me at the daytime phone listed above.

Please provide your customer account number (if known):

Customer Acc't Number

 

	SHIPPING INFORMATION ( IF DIFFERENT THAN BILLING INFORMATION )
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

 

YOUR ORDER:
QTY	DESCRIPTION

 

Questions or comments:

Have you ordered directly from Southern Cricket Wholesale before?

Yes No

**All orders will be confirmed via email within 24 business hours**
(Freight is extra. In the winter there may be cold packing charges.)

Copyright © 2000 [Southern Cricket Wholesale, Inc.].
All rights reserved. Revised: January 22, 2003