Fax Order Form~ Click PRINT, then FILL OUT, & FAX in...

fax order form

EAR CHARMS™ INC. 1855 LAGUNA CANYON ROAD LAGUNA BEACH, CA 92651 ORDERS: 1-800-998-3277(9am-5pm PST) TEL: 949-494-4147 FAX: 949-376-0205	ORDER FORM 2001 ORDER DATE:_____________ TAKEN BY:________________ FILLED BY:________________ SHIPPED BY:_______________ *WHOLESALE#: ___________________________
SHIP TO: NAME:______________________________ ADDRESS:___________________________ ____________________________________ ____________________________________ ____________________________________ EMAIL:_____________________	SOLD TO: NAME:_____________________________ ADDRESS:__________________________ ____________________________________ ____________________________________ DAY PHONE:_______________ EVE. PHONE: _______________ FAX NUMBER:______________ EMAIL:_____________________

METHOD OF PAYMENT:\|___\|	Subtotal:	$__.__
CHECK OR MONEY ORDER ENCLOSED: [if sending in this order form to above address]	Tax 7.75% (CA Res. Only)	$__.__
Credit Card Orders: [put 'X' by Credit Card Type]	Shipping Handling* *(.40 per $100 ordered for insurance)	$_6.95
\|___\|M/C\| \|___\|VISA\| \|___\| AM.EX.\| \|___\|Discover\|	Order Total	$__.__
CC#________________________________ Exp Date:__________________ Signature:____________________________	Print, Fill Out, Send in, and/or Fax to: 1-949-376-0205

How did you hear of us?_________________________________________________
Are these for male or female?_______________________ Approximate Age?_______

*WHOLESALE - 1st Order Min. is $250,
After 1st Order, Min. is $100.
Thank Your For Ordering Ear Charms™