Easymade --
Manual Order Form
Please print this page
(Note - It should print as more than one
page. If you experience
problems printing the form, click here for
some hints.)
and mail to the address below.
Or call us at 818-379-9612; Fax:
818-905-6618
Note: If
you would like to place your order online through our secure store,
Click
here for instructions,
place items in your cart and then follow the links to check
out.
| Name: | Date: |
| Street Address: | |
| PO Box: | |
| City: | State: |
| Country: | Zip: |
| Daytime Telephone: ( ) Fax: ( ) | |
| E-mail: | |
Payment
Method:
 Check
Money Order
Visa
MasterCard
Discover |
|
| Card # | Exp. Date: ___ /___ |
| Signature: | Member #____ |
| Item # | Quantity | Price Each | Total | |
| 1.) | $ | $ | ||
| Description: | ||||
| 2.) | $ | $ | ||
| Description: | ||||
| 3.) | $ | $ | ||
| Description: | ||||
| 4.) | $ | $ | ||
| Description: | ||||
| 5.) | $ | $ | ||
| Description | ||||
| 6.) | ||||
| Description | ||||
| 7.) | ||||
| Description | ||||
| 8.) | ||||
| Description | ||||
|
For additional items, please list on a separate page |
||||
|
Domestic Shipping & Handling Fees |
Subtotal: |
$ |
| Purchases up to $10.00 . . . $1.95 | ||
| $10.01 to $30.00 . . . $4.95 |
Shipping & Handling* |
$ |
| $30.01 to $40.00 . . . $5.95 | ||
| $40.01 to $50.00 . . . $6.95 | ||
| $50.01 to $65.00 . . . $7.95 |
Int'l please specify shipping method: |
$ |
| $65.01 to $85.00 . . . $8.95 | ||
| $85.01 to $100.00 . . . $9.95 |
Order Total: |
$ |
| Over $100.00 . . . FREE | ||
|
Orders are generally shipped by International
Shipping & Handling Fees |
Notes: California Residents need to add 8.25% Sales Tax | |
|
Printing Hints: Some printers may have difficulty printing both pages of this form. If you are having problems printing the second page, select Print from the File Menu in your browser window, and then under Print Range, select pages 2 to 2.
Please note: If you experience any problems with our site, please call 818-379-9612
or e-mail admin@easymade.com
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