poordebs.com Snail Mail Order Form


TO ORDER BY SNAIL MAIL: PRINT THIS FORM.  Mail to:
DEBORAH HERNDON
c/o PoorDebs.com
702 WHITE CHAPEL RD
CARRIERE,MS 39426, USA
Make check or Money Order payable to: DEBORAH HERNDON 
 *INDICATES REQUIRED FIELD.  IF YOU ARE PRINTING THIS FORM, THIS MEANS THAT YOU ARE PAYING BY PERSONAL CHECK OR MONEY ORDER OR CASHIER'S CHECK OR CASH THROUGH THE MAIL.  MUST BE U.S. FUNDS DRAWN ON U.S. BANK OR U.S. CASH.  NO EXCEPTIONS.  CREDIT CARDS ARE ACCEPTED THROUGH PAYPAL.COM ONLY ONLINE! 

 
 *NAME:_______________________________________________________________________

 *ADDRESS:____________________________________________________________________

 *CITY:___________________________________*STATE:_______ZIP CODE:________________

 *COUNTRY:__________________________ *PROVINCE:_________________________________

 *EMAIL ADDRESS:_______________________________________________________________

 *PHONE NUMBER:________________________________________________________________
 
ITEM# ITEM DESCRIPTION, COLOR, IMAGE COLOR SIZE QUANTITY PRICE TOTAL
           
           
           
           
           
           
           
Special Instructions:


 		SUB TOTAL  
***SHIPPING

 
GRAND TOTAL  

***Shipping is $4.00 for one item. Add $1.00 for each additional item.

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