Today's Date___________________
Telephone : 480-585-9608 Tues - Fri 9 am - 3 pm.
or 480-478-4001 ( 24 hour messaging )
Allow 1 - 72 hours for response please.
1. Mail form: Telephone to obtain the city & street address to send this form.
2. Email form to: orders@faithcenteredresources.com
3. Fax Form: Call to obtain the fax telephone number please
YOUR NAME / ADDRESS INFO
Very Important :
Need phone number so we can contact you, and an email address if you have email.
If Shipping to Another Name / Address Complete Ship-to section
Please Print Clearly
Name ____________________________________________________________________________________
Address __________________________________________________________________________________
City____________________________________ State____________________________ Zip _______________
Phone Home ( )_________________________ Work or Cell ( ) _________________________________
Email Address ( very helpful if you have one ) __________________________________________________________
SHIP TO NAME / ADDRESS ( Can leave blank if the same as above )
Name ____________________________________________________________________________________
Address __________________________________________________________________________________
City____________________________________ State____________________________ Zip _______________
Phone Home ( )_________________________ Work or Cell ( ) _________________________________
ORDER ITEMS
Please enter prices in U.S. dollars
Name of book, tape, CD, DVD, movie, product etc.
|
Product ID#
from shopping
cart
|
Price / each
|
Quantity
|
Total
Cost of
Product
|
| #1 |
|
|
|
$
|
| #2 |
|
|
|
$
|
| #3 |
|
|
|
$
|
| #4 |
|
|
|
$
|
| #5 |
|
|
|
$
|
| #6 |
|
|
|
$
|
| #7 |
|
|
|
$
|
| #8 |
|
|
|
$
|
| #9 |
|
|
|
$
|
| #10 |
|
|
|
$
|
|
|
|
|
|
|
#13. Sub Total ( Cost of Product )
|
$
|
| #14. *Postage Charges ( Use Postage Chart below )
add postage here
|
$
|
|
#15. Handling
|
$1.50
|
|
#16. Sales Tax (
Arizona residents ONLY )
- add 9% of product cost.
Example: product cost is $25.00 x .09 = $2.25
|
$
|
|
#17. TOTAL. Add lines 13, 14, 15 & 16 here
|
$
|
**Use this Postage Rates Chart for postage for Domestic orders
( International when you contact we will calculate )
Product Cost Total
|
*Delivery cost
|
* Note: Typical Delivery time
USA 1-2 wks
International 2-3 weeks.
|
| Up to $29.99
|
$7.95
|
|
| $30.00 - $49.99
|
$8.95
|
|
| $50.00 - $99.99
|
$9.95
|
| $100.00 - $199.99
|
$12.95
|
| $200 - $499.00
|
$14.95
|
|
CREDIT CARD INFORMATION
Note: All Fax Sales are Credit Card Only
Card Type - Put an 'X' in the box
_____MasterCard_____VISA_____Discover_____American Express
|
Card # _____________ - _____________ - ______________ - _____________
Exp. Date_______ - _________
CVV2 ( Security Code ) __________
3 numbers from back of card near signature area for Visa, MC, Disc
|
Name as it appears on the card
__________________________________________
|
Credit card statement sent to address listed above ??
( yes )_________( no )_________
|
Signature__________________________________________________
|
|
|
