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MAIL ORDER & FAX ORDER FORM - WHOLESALE ( OUTSIDE U.S.A. CUSTOMER ) |
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FOR MAIL ORDERING. Please fill up this order form and print it. For PHONE ORDER, Click here. |
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| Name: | |||
| Address: | |||
| E-mail: | |||
| Phone: Date: | |||
| Item # | Description | Quantity | Total |
| $ | |||
| $ | |||
| $ | |||
| $ | |||
| $ | |||
| $ | |||
| $ | |||
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Total Purchases after discount: |
$ | |
Shipping and Handling Charges |
$ | ||
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Total amount you need to pay. |
$ | ||
| MODES OF PAYMENT (Check one please) | |||
| 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. |
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| Signature________________________________________ Date: ___________________ | ||
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Note: Outside USA Customer - Order is limited to $500.00 |
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| Copyright
© [YEPEY]. All rights reserved. Registered Trade Names: YEPEY Licensed as Sole Proprietorship Address: 1319 S. Cougar Dr., Moses Lake, WA 98837 USA |