Credit Card Authorization

 

Credit Card Type: VISA or MASTERCARD (circle one)

Name (as it appears on Credit Card):____________________________________________________

Card Number:_____________________________________________________________________

Expiration Date:__________________________

 

Billing Address:

Address:__________________________________________________________

City:________________________________State__________Zip_____________

 

Shipping Address(if different than above):

Address:__________________________________________________________

City:________________________________State__________Zip_____________

 

Phone:_____________________________________________

Please Add me to your E-mail notification list for new products as they become available.

E-mail: ___________________________________________________________

 

I authorize Digital Dreams Entertainment to charge my credit card for $____________._____ for the purchase
of the the CD-ROM - DD3D01(Kat 3-D) - DD3D02(Fauve 3-D) - DD3D03(Paulina 3-D) (circle all that apply)

I certify that I am 18 years of age or older.

Signature:__________________________________________________________

Your credit card will be billed as "Digital Dreams Entertainment".

For billing inquiries write to: P.O. Box 2689, Dept. WM, Costa Mesa, CA 92628-2689 or call (714) 545-1135