Print and fill out this order form, mailing it to:
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Bill To: Name:____________________________ Address:__________________________ City:________________ State:____ Zip:________ Daytime Phone Number:_______________ |
Ship To: Name:____________________________ Address:__________________________ City:___________________ State:_____ Zip:_________ |
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Item Number |
Description |
Quantity |
Price each |
Total |
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Sub-Total |
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VA Residents add 4.5% sales tax |
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Shipping Included In Price |
$0.00 |
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Grand Total |
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Please Make Checks Payable to The Added Touch.
Credit card information
MC ___ VISA___
Card Number _________________
Expiration Date __________
Signature ______________________