Petticoat Junction - Printable Order Form

Mailing Address:
Petticoat Junction Dance Shop
14523 Hwy 99, #1
Lynnwood, WA 98087
FAX: (425) 742-3110

PRINTABLE ORDER FORM

littlelogo.jpg (7809 bytes)

QTY	ITEM#	DESCRIPTION / SIZE / COLOR	PRICE	TOTAL










8.9% TAX for WA residents Shipping is FREE for domestic orders of $80.00 or more! For orders totaling $0-*$15.00, add $3.99; orders $15.01-$79.99, add $5.99. International Orders: An additional $6.00 shipping charge will be added to all international orders. We will contact you to discuss the best way to ship to your country and the delivery date the order is desired. Shipping charges may need adjusting to accommodate the needs. URGENT DELIVERY IS AVAILABLE, View information about our shipping, pricing and return policies.			Subtotal
			Tax *
			Shipping
			Total

Enclose check or money order, or charge credit card:

CREDIT CARD:	BILLING INFORMATION
Credit Card	(Visa, MasterCard, Discover, Amex)
Cardholder Name
Card Number
Expiration Date	CCV Code (Numbers shown on back of card)

To have merchandise shipped, add appropriate charges as listed and fill out the information below.

ORDERED BY:	CUSTOMER/SHIP TO INFORMATION
Phone Number
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country