Klassy Lady

PRINTABLE ORDER ORDER

To complete this form, print, fill out & fax to:  (951) 687-7869

NAME:   DATE:  
ADDRESS:   TELEPHONE:  
CITY:   EMAIL:  
STATE, ZIP   FAX:  
PLEASE PRINT ALL INFORMATION
QTY PRODUCT # DESCRIPTION UNIT COST TOTAL
         
         
         
         
         
         
         
         
         
         
         
         
    SUB-TOTAL    
    (See below for shipping cost)  SHIPPING:     
    TOTAL    
Please print clearly                              
Visa, MC or Discover  
Account Number:  
Name on Card:  
Address for Card:  
Expiration Date:  
Signature: