Billing Address:* | Ship To: (if different) |
---|---|
Name: | Name: |
Address: | Address: |
City: | City: |
State:_________Zip Code: | State:_________Zip Code: |
E-mail Address: | E-mail Address: |
Phone Number: | Phone Number: |
QTY: | SIZE: |
|
ITEM COLOR: | UNIT PRICE: | TOTAL: |
---|---|---|---|---|---|
- | - | - | $ | $ | |
- | - | - | $ | $ | |
- | - | - | $ | $ | |
- | - | - | $ | $ | |
- | - | - | $ | $ | |
- | - | - | $ | $ | |
- | - | - | $ | $ | |
- | - | - | $ | $ | |
- | - | - | $ | $ | |
- | - | - | $ | $ |
Merchandise Total: | $ |
Shipping FREE if Shirt/s shipped in USA: | $ |
TOTAL: | $ |
___Money Order
Enclosed (make M.O. payable to Charm & Happy) |
$_________________ |
Mastercard | _____ | Visa | _____ | American Express | _____ | Discover | _____ |
CARD NUMBER:__________________________________EXP DATE:____-____ SIGNATURE: (Required on all credit cards)___________________________________ *Must agree to credit card billing address, if using credit card. |
|
|
|
Up to $25 | $8 | |
$26 - $50 | $10 | |
$51 - $75 | $12 | |
$76 - $100 | $14 | |
$101 - up | $16 |