Order Form
Thank you. Please print out the
form and fax it to us
at (419) 593-9484. 
If you would like to order
by mail, please send
this form with check or money order to the address on our Contact Info. Page.
|
Ordered by (Name): |
____________________________ |
|
Address 1: |
____________________________ |
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Address 2: |
____________________________ |
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City, State: |
____________________________ |
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Zip: |
____________________________ |
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Contact Phone Number: (if we have a question) |
(_____)______________________ |
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Ship to (Name): |
____________________________ |
|
Address 1: |
____________________________ |
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Address 2: |
____________________________ |
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City, State: |
____________________________ |
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Zip: |
____________________________ |
|
Contact Phone Number (if we have a question) |
(_____)______________________ |
|
Qty |
Item |
Item Price |
Total Price |
|
|
Places Everyone |
$49.95 |
$49.95 |
| Places Everyone Double Kit | $94.90 | ||
| ___ | Three's-A-Breeze Kit | $148.00 | ______ |
| ___ | Bark Mitzvah Kit | $49.95 | ______ |
|
___ |
Additional People Placers (25) |
$5.00 |
______ |
|
___ |
Small Round Tables (5) |
$3.50 |
______ |
|
___ |
Large Round Tables (5) |
$5.00 |
______ |
|
___ |
Rectangle Tables (4) |
$3.50 |
______ |
|
|
|
______ |
|
| COUPONS/DISCOUNTS | ______ | ||
|
|
Total |
|
______ |
Dog's Name (for Bark Mitzvah Kit) _________________________________________
| Credit Card Number: | |||||||||||||||
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Expiration Date |
__________________________ |
|
Signature |
__________________________ |
Credit Card Type: (Circle one) Visa, MasterCard, Discover/Novus, American Express
| Shipping/Handling Charges: | ||||
|
Total Cost: |
$0.01-$49.99 |
$50.00-$74.99 |
$75.00-$99.99 |
Over $100.00 |
| Three's-A-Breeze Kit | NO ADDITIONAL SHIPPING COST | |||
|
US Shipping |
$8.95 |
$10.95 |
$16.95 |
Please Call |
| Please
add $19.00 for 2nd Day Delivery. Please
add $32.50 for overnight delivery. |
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THANK
YOU!