Fax Ordering Form   

The following is a Fax Ordering Form. Customers  who don't feel comfortable transmitting credit card information over the internet can print this form, complete it and fax it to 888-626-0520 or contact Customer Service at 888-626-0520, option 1:

Please enter your name:

Name

Please provide the following contact information.( Note: Please ensure that the address used here is the same as the billing address for your credit card.):

Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
FAX
E-mail

Please provide the following ordering information:

QTY DESCRIPTION

BILLING
Credit Card #:
Account Name:
Expiration Date:
V code:  
Signature
Date

SHIPPING
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
 

Copyright © 2002 Ethnic Inspirations by Marshaé ™. All rights reserved.
Revised: 06/22/06