Sold To:
Full Name: ________________________________ E-mail: ________________________________
Address: ______________________________ City : __________________________ Suite: _____
ST: __________ Zip: ________ Phone: _________________________ Cell: _________________
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Ship To:
Address: ______________________________ City : __________________________ Suite: _____
ST: __________ Zip: ________ Phone: _________________________ Cell: __________________
Comments: ___________________________________________________________________________
Full Name: ________________________________ E-mail: ________________________________
Address: ______________________________ City : __________________________ Suite: _____
ST: __________ Zip: ________ Phone: _________________________ Cell: _________________
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Ship To:
Address: ______________________________ City : __________________________ Suite: _____
ST: __________ Zip: ________ Phone: _________________________ Cell: __________________
Comments: ___________________________________________________________________________
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| Add Mathews Bucks Total Don't forget to send Mathews Bucks |
| Merchandise Total |
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Subtract
Mathews Bucks
from
above and Enter any Cash if necessary |
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Enter Sales Tax 6% if living in Kentucky
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Enter Shipping
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Enter Total Amount
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Shipping Chart
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00.01 to 19.99 = $ 9.95 |
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20.00 to 49.99 = $18.95 |
| 200.00 to 299.00 = $64.95 |
| 300.00 and Up add = $10% |
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100.00 to 199.99 = $49.95 |
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50.00 to 99.99 = $26.95 |
Charge this order to my
Circle One
Circle One
Card Number _____________________________________
Exp Date: Mo__________ Yr __________
By signing below you authorize us to debit your credit card credit card
Signature ________________________________________
your card will be billed via Paypal
Exp Date: Mo__________ Yr __________
By signing below you authorize us to debit your credit card credit card
Signature ________________________________________
your card will be billed via Paypal
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Mail to:
453 Tabler Ave,
Harrodsburg, KY 40330
453 Tabler Ave,
Harrodsburg, KY 40330
Thank you for your order
LAY-A-WAY ORDER FORM
All rights reserved copyright
NewWave
2009
Mathews, Photo Arts
. and Home Décor.
Click Here For Rules
Please, Don't forget to send your
Mathews Bucks
Mathews Bucks
Enclosed is the full payment of my order $_____________
Payable To: Mathews
Paid by: Circle one:
Personal Check Money Order Certified Check
Payable To: Mathews
Paid by: Circle one:
Personal Check Money Order Certified Check
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and Home Decor
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