Mane Street order form

Before ordering, make sure you have read our policy & privacy policy pages.

ITEM NO.

DESCRIPTION

SIZE

QUANTITY

UNIT COST

TOTAL AMOUNT

SHIPPING CHARGES:

UP TO $25.00 -------------------------------------$4.95
$25.01 TO $50.00----------------------------------$6.95
$50.01 TO $75.00----------------------------------$8.95
$75.01 TO $100.00--------------------------------$10.95
$100.01 TO $200.00-------------------------------$14.95
$201.00 TO $400.00-------------------------------$17.95
$401.00 or more----------------------------------$29.00

Special items such as jewelry, prints and larger/ heavier items will be calculated on an individual basis.

SUB TOTAL:

      NJ RESIDENTS ADD 6% SALES TAX:

SHIPPING CHARGES:

GRAND TOTAL DUE:

BILL TO NAME:                                            PHONE:

SHIP TO NAME: (if same as billing put same)   PHONE:
         

ADDRESS 1:
ADDRESS 2:

ADDRESS 1:

ADDRESS 2:
CITY: STATE: CITY:STATE:
ZIP:

ZIP:

E-Mail Address


Visa

  MasterCard

    Discover

Amex

If you do not want to give your credit card information online, prefer to pay by check or have questions before ordering, feel free to print out this order form and fax your order (24hrs. a day) to (201)933-4744 or call (201)933-5555 to place your order.  Use code INT.

Exp. Date:
 /

Card #:

SPECIAL INSTRUCTIONS

By submitting this form, you are electronically signing this document and are bound by the terms set forth on the policy page.  You agree to pay all fees as specified by your order form.  Also by submitting this form, you are stating that you have legal rights to use the credit information as placed on this page, should you be found guilty of fraudulent charges on the account, you will be prosecuted according to the laws in the area where you live.

THIS IS A SECURE ORDER FORM!