Please complete and e-mail/fax the form below to authorize us to process your payments on your credit card. Upon completion of this form, you authorize Cantex Distribution Inc. to process payment for future payments on your credit card unless otherwise requested by you. Cantex Distribution Inc. will keep all credit card information confidential at all times. You may cancel this authorization at any time by contacting us. This authorization will remain in effect until cancelled.
If you do not have Adobe Reader, download it free by clicking on "Download Adobe Reader".