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Fax and Mail Forms

Print Out A Form For Custom Order Payments


This is the area of our shopping cart that is used to generate Fax and Mail Forms to accompany your method of payment to Xds of North Wales, PA for pre-arranged custom orders only.

Use of this page and web cart authorizes Xds of North Wales, PA to bill your credit card for the total amount of your Custom Order -- including shipping costs -- which were previously disclosed to you and with which you are in agreement.

Do not place any other items into your shopping cart for this transaction.


1. Click on the "Add to Cart" button below.
2. On the page that appears, scroll down to “Payment Options”.
3. Click on either “Print An Order Form and Pay by Mail” or “Print An Order Form and Pay by Fax" option.
4. Click on “Special Ship: Customer Agrees to Added Charges”, which shows a value of $0.10.
5. Then continue to follow the directions that appear on your screen.
6. Print out your form. Include your method of payment, sign the signature area, and send the form to us.

We accept Visa, Mastercard and Discover





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