Payment Method
Money Order
Check
Credit Card
Shipping Address
Name:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Telephone:
E-mail:
Billing Address (Fill out only if different from shipping address and if paying by credit card)
Name:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Telephone:
E-mail:
Money Orders/Checks
Please fill out, print and mail this form along with payment
cashable in USA dollars
to:
Carolyn's Facial Fitness™ LLC
14581 Tree Top Lane NW
Seabeck, WA 98380
Credit Card Information
Name:
Credit Card Type
Visa
MasterCard
Discover
American Express
Credit Card #
Expiration
CVV/CVC
Qty
Item Name
Unit Price
Total Price
Subtotal
Shipping (USPS Priority Mail)
Grand Total