www.luminanti.com ORDER FORM

ORDER Form

11-07-11

To order, please follow these 4 easy steps
or call us at 919-563-1600

Click this link order@luminanti.com to open a blank email page
Copy and paste the information listed BELOW this yellow box into the blank email created in step 1
Edit the email to answer each item in the list.
Then click "Send" to send the email

We will process your order as soon as we receive it.
Shipping/Insurance (S/I) will be calculated for each order.
We charge the actual UPS or USPS shipping charge.
We only charge a handling fee for orders paid for via PayPal.

Copy into email and email to order@luminanti.com

ALL the information below MUST BE COMPLETED

List the items you are ordering and the price:
(for Gift Certificates, specify "Gift Certificate" and Total Amount)
Name of the person the order is shipping to: ________________________________
Name of the person who is placing the order (if different from above): _______________________
Shipping Address
Street Line 1:
Street Line 2:
City:
State/Province:
Zip/Postal Code:
Country:
Is the shipping address RESIDENTIAL COMMERCIAL
Daytime phone number of the person who is placing the order: _____________________
Daytime phone number of the person who the order is shipping to (if different from above):
Email address (to send your Receipt and Tracking #): _________________________________
VISA MASTERCARD AMERICAN EXPRESS DISCOVER
Diners Club BC JCB Dinacard Union Pay
CREDIT CARD DEBIT/CHECK CARD
Credit/Debit Number: ________________________________
Send in one of 3 ways:
a. Fax to 919-563-1522.
b. Email the first half of the number in one email and the rest in a second email for security. Email to order@luminanti.com.
c. Call us at 919-563-1600. If no one is available to speak with you, you can leave it on our secure voice mail.
Expiry Date:___________
3-digit CVV2# (on back of card) OR 4-digit CID# (on front of Am Express card): _____________
Name on credit/debit card: _________________________________________
Billing Address where your credit/debit card STATEMENT is sent to.
We MUST have the billing address to process your order.
Same as shipping above
Different Address Complete BILLING ADDRESS information below:
Street Line 1:
Street Line 2:
City:
State/Province:
Zip/Postal Code:
Country:
For USA and CANADA orders ONLY, we ship UPS Ground unless you specify to ship via USPS. If you want express delivery (extra charge) please circle either: 3-day, 2-day or Next Day. To all other countries, we ship Express Mail International (EMI). We do not express mail the Golden 'C' Water.
Please note any other instructions, comments, or requirements.
(if you are sending a Gift Certificate, specify the message you'd like to send)