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ORDER FORM |
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FOR MAIL ORDERING, FAX ORDERING. Please fill up this order form and print it. FOR INTERNATIONAL CUSTOMER Click here. |
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| Name: | |||
| Address: | |||
| E-mail: | |||
| Phone: | |||
| Item # | Description | Quantity | Total |
| $ | |||
| $ | |||
| $ | |||
| $ | |||
| $ | |||
| $ | |||
| $ | |||
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Total Purchases after discount: |
$ | |
| Add $6.50. for Shipping and Handling charges. Note: Free Shipping and Handling charges if your total purchase is over $50.00. | $ | ||
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Total amount you need to pay. |
$ | ||
| MODES OF PAYMENT (Check one please) | |||
| Check or Money Order | VISA | MasterCard | Discover |
| Credit Card Information | ||
| Name on Card: | ||
| Credit Card Number | Expiration Date: MM,YY | C.I. D. CODE. The C.I.D. code is the last 3 digit numbers on the back of your credit card. |
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| Signature________________________________________ Date: ___________________ | ||
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Note: The Surcharge of Insufficient Check will be $25.00. For Credit card user, please don't forget to sign these form. |
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Yepey is Licensed as Sole Proprietorship |
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Web: www.cabinets-jewelryboxes-chest.yepey.us - E-mail: judithsmith@yepey.us |
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Address: 1319 S. Cougar Dr., Moses Lake, WA 98837-9799 USA |