THE DANCER'S SHOP ONLINE ORDER FORM |
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Purchased By |
Shipping Address |
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Name |
Date |
Name |
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Address |
Address |
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Address |
Address |
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City |
State |
Zip |
City |
State |
Zip |
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Home Phone ( ) |
Work Phone ( ) |
Shipping Method |
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Are there any special show dates? |
Yes |
No |
For Office Use |
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Dates: |
Date Shipped: |
Method |
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METHOD OF PAYMENT |
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Check or Money Order |
VISA |
Card number |
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Master Card |
Discover |
Expiration Date |
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COD ($5.25 Charge) |
American Express |
Signature |
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ITEMS |
Qty |
Style# |
1st Color |
2nd Color |
Size |
Width |
Description |
Unit |
Total |
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Subtotal |
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Shipping |
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COD Charge |
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CT Residents add 6% sales tax |
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Total |
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The Dancer Shop (203) 498-STEP *
1-(888)-822-DANCE * 1-(800) 822-DANCE *
Fax (203) 562-8424 |