Your Name____________________________________________________________
Address_______________________________________________________________
City, State, Zip, Country___________________________________________________
SHIP TO:______________________________
______________________________________
______________________________________
BILL TO:_____________________________
______________________________________
______________________________________
PAYMENT INFORMATION
Credit Card #:__________________________________
Exp. Date_________________
Circle One: Mastercard Visa Amex Discover
Photo Included: Yes No
Your Signature______________________________
Today's Date__________________
Please fill out as completely as possible. Describe in full detail. Include SIZE, COLOR and any other information needed.
ITEM # QTY. DESCRIPTION PRICE EACH TOTAL AMT.
_______________________________________________________________ _
Subtotal:______________
(Sales tax in Calif) Tax:______________
Shipping/Handling:______________
(Rush Order - 2 Weeks - ADD $20.00):______________
YOU PAY THIS AMOUNT:______________
MAIL THE COMPLETED ORDER FORM TO:
Include all necessary photos and instructions.
Please allow 4-6 weeks for delivery.