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Beloved Embroidery 386-938-2441 Checks, Money Orders, Credit Cards We only ship within the U.S.A.
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| Item #
Description
Color
Qty
Unit Price Total Price ------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------ |
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Subtotal:
$__________
FL tax @ 7% __________ Shipping: _$5.00_ Total Enclosed: $__________ ------------------------------------------------- |
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If paying by Mastercard,
Discover, or Visa, please fill out below:
Mastercard_____
Discover_____ Visa_____
Card Number: _______________________________________ Card Expiration Date: ___________________ CCV number on back of card: (usually a 3 or 4 digit number) ______ Phone # for MC, Discover, or Visa: _______________________________ Cardholder Name: _________________________________ Cardholder Billing Address: __________________________________ City: ______________________ State: _______ Zip: ________ SIGNATURE:________________________________________________ |
| Ship To:
Name: _________________________________________ Street Address: _________________________________________ City, State & Zip: _________________________________________ Phone#:
________________________________________________ E-mail:
_________________________________________________ |
| Please make
checks/money
orders payable to Nancy Britt
and mail to the address below.
Nancy Britt |