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Please Print This Page To Get An Order Form Fax to (209) 755-3767 |
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| Item Number | Description | Qnty | Price($) | Catalogue Name | |||||
| 1. | _______ | ______________________ | ______ | ________ | _____________ | ||||
| 2. | _______ | ______________________ | ______ | ________ | _____________ | ||||
| 3. | _______ | ______________________ | ______ | ________ | _____________ | ||||
| 4. | _______ | ______________________ | ______ | ________ | _____________ | ||||
| 5. | _______ | ______________________ | ______ | ________ | _____________ | ||||
| 6. | _______ | ______________________ | ______ | ________ | _____________ | ||||
| 7. | _______ | ______________________ | ______ | ________ | _____________ | ||||
| 8. | _______ | ______________________ | ______ | ________ | _____________ | ||||
| 9. | _______ | ______________________ | ______ | ________ | _____________ | ||||
| 10. | _______ | ______________________ | ______ | ________ | _____________ | ||||
| Total: | ________ | ||||||||
| Shipping Charges will be added | |||||||||
| ____ Please check here if you want shipping costs quoted before order is sent. Phone number or email address is required | |||||||||
| Payment Information | |||||||||
| Credit Cards: Visa—MC—Discover-American Express (circle one) | |||||||||
| Card #:_______________________________ | |||||||||
| Exp. Date: _________ Security code: ____ (last 3 digits on signature line - back of card) | |||||||||
| Name: _______________________________ | |||||||||
| Address: _______________________________ (must be same as billing address) | |||||||||
| City: __________________________ State: ____ Zip: ________ | |||||||||
| Phone: _____________________ | |||||||||
| Email: ______________________________________ | |||||||||
| Fax: _____________________ | |||||||||
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Phone: Mini Temptations 913-648-2050
or 1-800-878-8469
Write: Mini Temptations 3633 W. 95th Street, Overland Park, KS 66206 © 1999-2007 This website is copyrighted
and may not
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