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MAIL ORDER & FAX ORDER  FORM - WHOLESALE ( U.S.A. CUSTOMER )
Mail Order Outside USA, click here

We only Accept Personal Check!

FOR MAIL ORDERING. Please fill up this order form and  print it. For PHONE ORDER, Click here.
Name:     
Address:  
E-mail:     
Phone:        Date:
Item # Description Quantity Total
$
$
$
$
$
$
$

.

Total Purchases after discount:

 $
Shipping and Handling Charges
Add $10.95 for Order up to $750.00
FREE SHIPPING ON ORDER OVER $750.00
$

Total amount you need to pay.

 $
MODES OF PAYMENT (Check one please)
Check or Money Order VISA MasterCard
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.
-

Signature________________________________________   Date: ___________________
  • MAIL Ordering: Mail this form along with your check or money order or credit card information. 
    • Make a check payable to YEPEY/ JUDITH SMITH. 
    • Mailing address: 
      • Yepey / Judith Smith
        1319 S. Cougar Dr. Moses Lake, 
        WA 98837-9799 USA
    • Enclose Check or Money Order.
    • Fax#: 1-509-765-0272. Fax order is available 24 hours.

Note: The Surcharge of Insufficient Check will be $25.00. For Credit card user, please don't forget to sign these form.

 

Copyright © [YEPEY]. All rights reserved.
Registered Trade Names: YEPEY
Licensed as Sole Proprietorship
Address: 1319 S. Cougar Dr., Moses Lake, WA 98837 USA