![]() | Order Form |
| Name:_____________________________ | Phone: (_____)___________________ |
| Address:___________________________ | Suite/Apt#:______________________ |
| City/State:_________________________ | Zip Code:________________________ |
| Shipping to Whom (if different)__________________________________ | Shipping Address (if different)________________________________ |
| City/State:__________________________ | Zip Code:________________________ |
| Credit Card Type____________________ | Name on Card____________________ |
| CC#______________________________ | Exp.Date________________________ |
| Quantity | Item # | Description/Color/Scent | Price X Quantity | Line Total | ||
| _________ | _________ | _____________________ | _____________________ | _________ | ||
| _________ | _________ | ______________________ | ______________________ | _________ | ||
| _________ | _________ | ______________________ | ______________________ | _________ | ||
| _________ | _________ | ______________________ | ______________________ | _________ | ||
| _________ | _________ | ______________________ | ______________________ | _________ | ||
| _________ | _________ | ______________________ | ______________________ | _________ | ||
| _________ | _________ | ______________________ | ______________________ | _________ | ||
| THANKS! For your business today! | Subtotal | _________ | ||||
| Special Instructions: | *Sales Tax | _________ | ||||
| **S & H | _________ | |||||
| TOTAL | _________ | |||||
| Up to $10.00-add $4.00 | $30.01-$45.00-add $10.00 | |
| $10.00-$20.00-add $6.00 | $45.01-$60.00-add $12.00 | |
| $20.01-$30.00-add $8.00 | $60.01-$75.00-add $14.00 | |
| $75.01-$90.00-add $16.00 |
| BecArt of Denison 830 West Crawford Street Denison, Texas 75020-4457 Phone: 903-464-9337 FAX: 903-464-9338 E-mail: becartofdenison@sbcglobal.net |