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.
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Product ID# from shopping cart
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Price / each
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Quantity
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Total Cost of Product
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#1 |
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$
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#2 |
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$
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#3 |
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$
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#4 |
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$
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#5 |
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$
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#6 |
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$
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#7 |
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$
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#8 |
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$
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#9 |
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$
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#10 |
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$
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#13. Sub Total ( Cost of Product )
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$
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#14. *Postage Charges ( Use Postage Chart below )
add postage here
|
$
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#15. Handling
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$1.50
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#16. Sales Tax (
Arizona residents ONLY )
- add 9% of product cost.
Example: product cost is $25.00 x .09 = $2.25
|
$
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#17. TOTAL. Add lines 13, 14, 15 & 16 here
|
$
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**Use this Postage Rates Chart for postage for Domestic orders
( International when you contact we will calculate )
Product Cost Total
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*Delivery cost
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* Note: Typical Delivery time
USA 1-2 wks
International 2-3 weeks.
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Up to $29.99
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$7.95
|
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$30.00 - $49.99
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$8.95
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$50.00 - $99.99
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$9.95
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$100.00 - $199.99
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$12.95
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$200 - $499.00
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$14.95
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CREDIT CARD INFORMATION
Note: All Fax Sales are Credit Card Only
Card Type - Put an 'X' in the box
_____MasterCard_____VISA_____Discover_____American Express
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Card # _____________ - _____________ - ______________ - _____________
Exp. Date_______ - _________
CVV2 ( Security Code ) __________
3 numbers from back of card near signature area for Visa, MC, Disc
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Name as it appears on the card
__________________________________________
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Credit card statement sent to address listed above ??
( yes )_________( no )_________
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Signature__________________________________________________
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