QTY

 

 

 

 

 

PART #

 

 

 

 

 

SIZE

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you may create your own order form.

 

 

DESCRIPTION
Necklace
Purchases

 

 

 

 

 

AMOUNT
                 
                 
                 
                 
                 
                 
No C.O.D.'s
SUB TOTAL
 
7% Tax- NJ Residents Only
 
Foreign Money Orders
Shipping & Handling
 
In U.S. Dollars Only
TOTAL
 
Name
Address
City
State/Country
Zip Code
Telephone
Email
Money Order
Personal Check
Cash (at your own risk!)
Make Payable to:
imosh.com
Shipping & Handling Charges
for U.S. & Canada Orders

Orders up to $49.99- $5
Orders from $50 to $79.99- $7
Orders from $80 to $99.99- $8
Orders $100 & Above- $10

Foreign Orders: DOUBLE the above

How did you find our website?
Magazine: ___________________ Date:_______
Website: _________________________________
imosh.com
P.O. Box 497, Dept WB1
Broadway, NJ 08808 usa

Credit Card Orders: (908) 689-6571
Visa
Mastercard
_ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _
Bank: _____________ Exp:_____
__________________________
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