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Printable Order Form

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               Printable Order Form


If you would rather order by mail, please print out this form and mail it to me at: Sammi Photo Art, 6400 West Main Street, Suite 1-O, Belleville, IL  62223.  Before you print this form PLEASE BE SURE TO ENTER WHAT TYPE OF CREDIT CARD YOU ARE USING BEFORE PRINTING THE FORM!

[FrontPage Save Results Component]

Please provide the following contact information:

First Name
Last Name
Middle Initial
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Please provide the following ordering information:

QTY DESCRIPTION

 

BILLING
Credit Card
Cardholder Name
Card Number
Expiration Date

 

SHIPPING
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
 


Copyright 2001 by Sammi Photo Art.  All rights reserved.
Revised: April 05, 2001