| Name: | |||||
| Address: | |||||
| City: State: Zip: | |||||
| Phone: Email Address: | |||||
ITEM |
ITEM DESCRIPTION |
QUANTITY |
PRICE |
TOTAL |
|
|
SHIP TO (If different Than Above) |
Merchandise Subtotal | ||||
| Name: |
Shipping
Surface (calculate based on subtotal above) |
||||
| Address: |
Air
Delivery (see added charge below) |
||||
| Address: |
IL
Orders (please add 8% sales tax) |
||||
| City: State: Zip: | TOTAL | $ | |||
| PAYMENT INFORMATION (U.S. FUNDS ONLY) | |||||
|
o Cashier's Check or Money Order
payable to Beauty of a Site. |
Credit Card o Visa o MasterCard o Discover o American Express |
Credit Card Number | |||
| Expiration Date | |||||
| Signature | |||||
SHIPPING & HANDLING CHARGES |
AIR DELIVERY SERVICE: |
||||
| Merchandise Subtotal | Via Surface | ||||
| $0 - $25.00 | $5.95 | ||||
| $25.01 - $50.00 | $6.95 | ||||
| $50.01 $75.00 | $8.95 | ||||
| Over $75.00 | FREE | ||||
|
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