Orderform


Name
Email
Street
Town/City
County
Postcode
Country
Telephone
Name on Credit Card
Credit Card or Check
Credit Card Number
Expiration Date

To order INSTANTLY by check just fill out the following form and click submit at the bottom of the form or you can receive a form in your email to fill out by click here.

The following fields are ALL REQUIRED!

Account Holder's Name as it appears on the Check

Check Number (record this check in your check book)
check order sample Fractional ABA number (for USA banks only - looks like 91-210/1225
Address if it is different than shipping address. Pay to the order of
Amount of Check Name of Bank
9 digit Bank Routing or Transit Number (Canadians MUST put a hyphen in the 6th position - all funds are US Dollars) City and State or Province where Bank is located
Your Account Number (include spaces and hyphens)
 

I authorize You to use Version 3.0 KwikChecks Pro software to print a check on my bank for the above selected items in the amounts shown. I understand that the check will show up just like any other check on my monthly bank statement. I also authorize you to draft my account electronically for the face amount of this check AND appropriate returned check fees if your check is returned unpaid. YOUR ORDER WILL NOT BE PROCESSED IF THIS LITTLE BOX IS NOT CHECKED!

This form will be processed without our having to re-type it. Please add a note in the comment field below if you would like information about our check processing software. (Please make sure the form is complete and accurate and NOTE that there will be a $20 charge for dishonored checks.)


If you prefer to fill out your information then fax your order with your credit card information you may do so to receive your order.

Sensei J. Richard Kirkham

275 Auwaiolimu #211

Honolulu HI 96813 (still a standard U.S. stamp)

Fax (808) 593-2522

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Web Master J. Richard Kirkham