Mail Order Form for The LaBoutique Shoppe
CLICK HERE TO RETURN TO LABOUTIQUE SHOPPE HOME PAGE
ORDER FORM
All from Nature
18950 US HWY 441 - PMB 206
Mt Dora, FL 32757
(352) 383-7861 FAX
e-mail:
YOUR MAILING ADDRESS
Your Name: ____________________________________________________
Street: _________________________________________________________
City, State, Zip: __________________________________________________
Your e-mail address (required): __________________________________
ITEMS ORDERED
|
ITEM # |
DESCRIPTION |
QTY |
PRICE |
TOTAL |
SUBTOTAL __________________
Florida Residents add SALES TAX (SUBTOTAL x 7%) _______________
SHIPPING AND HANDLING
($1 - $50 = $5) ($51 - $100 = $8.00) ($101 - $200 = $11.00) _____________
($201 - $300 = $14) Free Shipping on Orders Over $300
TOTAL (Check or Money Order) ______________
To order by check or money order print this form and MAIL