Emerald Garden: Order Form

Polishing Cloth

$5.00 w/Purchase
Stock# 55555

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Three convenient ways to order:
Online • Phone • Fax

We accept all major credit cards!

Name/Shipping Address: * All Fields Required

Name:

Address:

City:

State: Zip Code:

E-mail:

Phone:

Payment Method:

Visa
MasterCard
Amex
Discover

Card Number:

Exp. Date:
/

C.O.D.
Other:

Items Ordered:

ID Number Product Name Size Qty Price Each Total Price

Shipping Method:

2nd Day Fed Ex (Prepaid)
$ 7.50

2nd Day Fed Ex (C.O.D.)
$14.50

US Post Office (Prepaid)
$ 6.50

US Post Office (C.O.D.)
$ 8.50

UPS (Prepaid)
$ 5.50

UPS (C.O.D.)
$10.50

UPS Air (Prepaid)
$ 7.50

UPS Air (C.O.D.)
$12.50

Subtotal:

Shipping:

Total:

Comments/Special Requests:

Order By Phone
281.367.0538

Order By Fax
Download the printable Order Form (PDF) found here,
fill out the order form completely and fax to:

281.367.7978 Fax

Acrobat Reader is needed to view and print file.
Download Acrobat Reader here.

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