Today's Date___________________
Please print or type this form.
Mail form ( with Cashier's Check, Money Order - No Personal Checks please )
Or enter your credit-debit card info at the bottom of this form
( Very Important - International Customers ! Make sure M.O. or check is in U.S. Dollars )
Telephone : 480-478-4001 ( 24 hour messaging )
Telephone or Email for street address to send Order to.
Allow 24-48 hours for response please.
Email form ( with Credit / Debit card info ) to:
orders@faithcenteredresources.com
Fax form ( with credit / debit card info ) to 480-585-9609
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 |
|
|
|
$
|
| #12 |
|
|
|
$
|
|
|
|
|
|
|
#13. Sub Total ( Cost of Product )
|
$
|
| #14. *Postage Charges ( Use Postage Chart below )
add postage on this line
|
$
|
|
#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 enter on line #17
|
$
|
**Use this Postage Rates Chart for postage for Domestic orders
( International we will calculate and contact you )
Product Cost Total
|
*Delivery cost
|
* Note: Delivery time
Domestic 1-3 wks
International 2-4 weeks.
|
| Up to $15.99
|
$7.95
|
|
| $16.00 - $49.99
|
$8.95
|
|
| $50.00 - $99.99
|
$9.95
|
| $100.00 - $199.99
|
$12.95
|
| $200 - $499.00
|
$14.95
|
|
CREDIT CARD INFORMATION
All Fax Sales are Credit Card Only - please enter information here
( Fax # - 480-585-9609 ) 24 hours
Card Type
___MasterCard___VISA___Discover___American Express
|
|
Card# _________ - __________ - ___________ - _________Exp. Date______ - ________
CVV2 ( Security Code ) __________
3 numbers off the back of the card in the signature area for Visa, MC, Disc
4 numbers off the front for AMX cards
|
| Name as it appears on the card________________________________
|
Credit card statement sent to address listed above ??
( yes )_____( no )_____
|
Signature__________________________________________________
|
|
|
