Bothfull Inc--Mail Order Form

http://store.myonlystore.com

To place a mail order: please print out this form and then fill it out clearly.

Last Name: _____________________  First Name: ___________________________

Address (line 1): ___________________________________________________________

Address (line 2): ________________________________________________________

City:  _____________________________   State: __________    Zip Code:  ________________

Your contact phone #'s (in case we have questions about your order):

Home (        )                                         Work (       )                                            

If you would like to receive our future promotions, please provide your Email Address:  _____________________________

 

Item # or Product Descriptions

Color

Unit Price

Qty

Total

 

 

 $

 

 $

 

 

 $

 

 $

 

 

 $

 

 $

 

 

 $

 

 $

 

 

 $

 

 $

 

 

 $

 

 $

 

 

 $

 

 $

 

 

 $

 

 $

Merchandise Total: 

$

 CA residents please add 9.75% sales tax: 

$

Shipping & Handling

$

Total Due: 

$

 

Please make check payable to: Bothfull Inc.  And send your payment with this order form to: 

Bothfull Inc

P.O. Box 940

San Gabriel, CA 91778-0940