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FAX ORDER USING YOUR CREDIT CARD. |
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FOR FAX ORDER. Please fill up this order form and fax it. 1-509-765-0272. Available 24 hours. For MAIL ORDER, Click here. |
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| Name: | |||
| Address: | |||
| E-mail: | |||
| Phone: | |||
| Item # | Description | Quantity | Total |
| $ | |||
| $ | |||
| $ | |||
| $ | |||
| $ | |||
| $ | |||
| $ | |||
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Total Purchases after discount: |
$ | |
| Add $10.95. for Shipping and Handling charges for Order up to $99.99. FREE Shipping for order $100.00 & above. | $ | ||
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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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| Copyright
© [YEPEY]. All rights reserved. Registered Trade Names: YEPEY Licensed as Sole Proprietorship Address: 1319 S. Cougar Dr., Moses Lake, WA 98837 USA |