Secure form for Credit Card transfer

Trinity Mineral Company * John Veevaert * 6152 Mia Vista Dr., Reno Nevada 89502 * (888) 689-8402

Secure Credit Card Information Transfer

Special thanks to Bob Keller for his help with this page!

You may use the form below to transmit your credit card information in a secure and encrypted format to facilitate your current order and all future orders. Once your credit card information is on file all future orders can filled expeditiously.

Use your mouse or Tab Key to access and fill-in all appropriate fields. You can leave "fields" or "check boxes" blank if they are not applicable.
If you leave the order form page before you've finished entering all your information and submitting it, use your browser's [BACK] button to return to this page to continue where you left off.
When you have completed all appropriate fields, click on the [SUBMIT NOW] button at the bottom of this page to send your information securely to Trinity Mineral Co.
You will be notified that your credit card information was received.

The following credit cards are accepted at
Trinity Mineral Company

If you want to mail your credit card information to Trinity Mineral Co. please send it to:

Trinity Mineral Company
6152 Mia Vista Dr.
Reno, Nevada 89502
USA

You can also call your credit card information in using my Toll Free phone number at: (888) 689-8402

If you prefer to provide your credit card information here a secure server will process this this form

Card Type: VisaMasterCardAMEXDiscover

Card Number: Expiration Date:

Name on the Card: (Name as it appears on the card - Include initial if present)

3 digit code on back of card
found on signature panel
(see example to the right)
AMEX card has a 4 digit number on front side Example:

Customer Information:

Please fill out this form also - Your specimens can not be sent to you unless I know where you live!
Please double check your email address. This is a place where mistakes are commonly made.
*= Required Field.

*First Name: *Initial: *Last:

*Address:

*Address:

*City: *State: *Zip:

*Country:

*Home Phone: Work Phone:

*Email Address:

Special Instructions:

Any comments or special instructions should be noted here.
For example: Send specimens to alternative address such as: work address. Or, send via Fed Ex instead of US Postal Service.
(Keep in mind that a request for using Fed Ex will increase the shipping costs substantially in most cases.)

Submit this Information:
Please check for typos and omissions -

- Click this button to submit your Credit Card information.

Thank You!!

Card Type:	VisaMasterCardAMEXDiscover
Card Number:		Expiration Date:
Name on the Card:		(Name as it appears on the card - Include initial if present)
3 digit code on back of card found on signature panel (see example to the right) AMEX card has a 4 digit number on front side		Example:

*First Name:	*Initial:	*Last:
*Address:
*Address:
*City:	*State:	*Zip:
*Country:
*Home Phone:		Work Phone:
*Email Address: