GAME PORT - On Line Video Order Form

MUST BE 18 TO ORDER...SOME STATES 21.
YOU ARE RESPONSIBLE FOR CHECKING YOUR LOCAL LAWS!!!!

GAME PORT
ON-LINE VIDEO Order Form Just click the 'Send Order' button at the bottom of this form to send your order after you have filled in all the necessary information.
or....CALL US TOLL FREE! (888)269-9866 TO PLACE YOUR ORDER GAME PORT accepts
MasterCard, VISA, AMerican EXpress
for the convenience of its e-mail customers.

This secure order form will encrypt the information you enter when it is submitted to Game Port.

VIDEO SELECTIONS
(Don't forget to list the company where the title is found)

Qty   Title & Company                                         Price
  
  
  
  
  
  
  
.................................SUB TOTAL  

...California Residents Add 8.00% Sales Tax  

.....SHIPPING (Please select options below)  

                                         TOTAL

SHIPPING and HANDLING PER ORDER:

All orders within the continental United States are shipped via UPS.
PO Boxes are shipped Priority Air Mail.
For INTERNATIONAL shipping , please e-mail request for shipping charges.
All videos are VHS NTSC format for the USA market.

E-Mail: customerservice@game-port.com PLEASE INCLUDE PROPER S&H IN TOTAL ABOVE

Shipping Rates Within USA Per Order:
UPS Ground $7.00 (N/A to HI & AK)
Priority Air Mail to PO Boxes $6.50
Priority Air Mail to street addresses: $6.50
UPS 3 Day Air: $10.00 (N/A to HI & AK)
UPS 2nd Day Air: $15.00
UPS Next Day Air: $28.00

Credit Card Information

Your Name Appearing on Card:

Credit Card Info
Card Type
Card Number	e.g. 1234-5678-9012-3456
Expiration Date (mm/yy)



BILLING ADDRESS:
Note: Your E-Mail Address must be filled in to receive order confirmation!

Your Name:        
Email address:    
Street:           
City:             
State:              
Zip:              
Country:          
Telephone:       


SHIPPING ADDRESS:


Name:             
Street:           
City:             
State:               
Zip:              
Country:          
Telephone:

ANY ALTERNATE TITLES:We will order for you what we don't have in stock, or please enter any alternate titles if we don't have your first choices in stock and any comments below.

"Document: Done" will appear at the bottom left of your screen when order has been sent, and a "Thank You" message will appear.
If your browser doesn't work with this form, then send all your ordering info by regular e-mail to customerservice@game-port.comAll duplicate orders will be deleted on our end if you should happen to send more than once.
Confirmation will be sent within 24 hours.
Thank You For Shopping GAME PORT!!!

Qty Title & Company Price

Credit Card Information

BILLING ADDRESS:Note: Your E-Mail Address must be filled in to receive order confirmation!

SHIPPING ADDRESS:

Return to Main Menu

BILLING ADDRESS:
Note: Your E-Mail Address must be filled in to receive order confirmation!