Step One - PayPal Checkout Process

## CART CONTENTS HERE

Purchased By:

First name:

Last name:

Company name:

Address:

City:

State / Province:

Zip / Postal Code:

Country:

Phone:

Email:

Ship To: ( if different from billing )

First name:

Last name:

Company name:

Address:

City:

State / Province:

Zip / Postal Code:

Country:

Select Shipping Method

Shipping Method:

Is this a Residential Address?

Misc Information

Special Notes: $eform_Ecom_XCOMMENT_Special_Notes

Only one more step! Please click the $agora_verify_order_button_text button below. This will give you the chance to examine your order one last time before you actually submit it to be processed.