Plexon Order Form Plexon Order Form Please fill out the below form. Name as it appears on card*Credit Card Number*Expiration Date (Month/Year)*Card Security Code*3 digit code on back of card or 4 digit code on the front of AmexCredit Card's Billing Address*Name of Person Authorizing Use of Card*Phone Number*Email* Today's Date*Quote Number*Purchase Order NumberUSD Amount*Bill-to address for shipment*Ship-to address for shipment*Shipping Method*3-Day2-DayOvernightFedEx International EconomyFedEx International Priority Select if you would like to receive our monthly newsletter
