IMPORT AND EXPORT EMPORIUM

PLEASE FILL OUT THE FOLLOWING INFORMATION TO PLACE AN ORDER!

ORDER FORM

INFORMATION
NAME
STREET ADDRESS
ADDRESS2
CITY
STATE
ZIP
TEL
FAX
EMAIL
DROP SHIP NAME
DROP ADD1
DROP ADD2
DROP CITY
DROP STATE
DROP ZIP
PAYMENT TYPE �
TYPE OF CREDIT CARD
EXACT NAME ON CARD
CARD NUMBER
EXPIRATION DATE MM/YY

CATALOG
ITEM
NUMBER		 CATALOG
ITEM
DESCRIPTION		 SIZE\
COLOR
(if applies)		 PACKING
(shown in
price list)		 COST PER PACKING
(As shown in
your price list)		 NUMBER OF
PACKING
ORDERED		 TOTAL
AMOUNT
SHIPPING INFORMATION

All orders are shipped within 24-48 hours after orders are received. Shipping time varies due to your location. RUSH SHIPPING is available but not recommended due to the high cost of shipping!

 COLUMN TOTAL
SHIPPING �
RUSH SHIPPING
SERVICE FEE
(add $2.50 for orders
less than $25.00)
GRAND TOTAL
(amount to be sent with order)

COMMENTS

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[email protected] Import and Export Emporium 40 Lakefront Ave. PO Box 4404 Gadsden, Al 35904 M.L. Helms, Tel {Toll Free}(888)546-8115 Fax (205)546-8115 or Please contact by e-mail at [email protected] (Customer Service).

copyright � M. L. Helms 1997 All Rights Reserved

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