Burger Custom Canes Order Form

Thank you for your order, by completing this secure order form I would just like to confirm- No debits will take place on your CC, until I have made contact with you, regarding a full break down of your order details and you have agreed to all costs and details. 
* Handle Choice (Please note our standard Turned Tamboti and Tee handles are included in the price. Our more unique handles add to the price of the cane) *
Shaft Finish
Break Down Conversion (Adds $180-00)
Shipping Information
SHIPPING - We ship our quality canes to all four corners of the globe, and assure you of very discreet and trouble free delivery of your order. Delivery will be 6-10 business days, at an approximate cost of $110-. Once I have received your confirmed order form I will follow up with final shipping costs and shipping date.
Is your credit card billing address the same as your shipping address?
American Express
 Card No (i.e. 1234-1234-1234-1234)
The privacy and security of your order are guaranteed.