Heidi Hats order Form Page 1
order form
Heidi Hat . 0040 Brown Court . CarBondale, Co 81623 . tel/fax 970.963.2565
ordered By
name
address
City
state
Zip
pHone
email
metHod of payment
CHeCk enClosed
visa
masterCard
Credit Card numBer
expiration date
CardHolder signature
3-digit seCurity Code
(on Credit Card BaCk)
Credit Card Billing information
(if not tHe same as ordered By)
name
address
City
state
Zip
style name
item Code Color
Color
siZe
Qty
unit priCe
total
primary
Contrasting
order suBtotal
sHipping/Handling
sales tax (if appliCaBle)
order total
speCial reQuest notes
-- see page 2 --
for produCt desCriptions and siZing
information, as well as for sHipping
CHarges and sales tax rates
sHip to
(only if different tHan ordered By)
name
address
City
state
Zip
pHone
today's date
