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PRINT OR COPY THIS ORDER OR
TYPE
ALL
INFORMATION BELOW
Date of Order:_______________________________
Approximate date* your order is needed ________________
Contact the Hampton to confirm Delivery date*(see Speedy Service if needed)
Fax Completed Form to
(757) 838-1668
OR e-mail form to
margosgreekshop@aol.com
Follow up with a call to
confirm receipt
of your order
Questions, call
(800) 572-1431 or
(757) 838-8346
Name:_____________________
Phone # ( )_____________ (H/W/Cell)
Address:________________________
City____________
State____Zip:______
Credit Card Number:_________________________
Expiration Date:________
3 digit Security Code:______
Billing Address for the Card: ___________________
City___________
State_____Zip:______
Shipping Address:
Ship to:_________________________
Resident or Commercial Delivery (circle one)Address:______________________
City_______________
State____Zip:_____
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Subtotal $__________
VA residents x .05 Sales Tax $____________
Shipping U.S. Mail $12 + Delivery Confirmation fee;
or UPS $14 (Call for orders over $80.00) $____________
Make check or money order payable to Creations by Margo Lynn, Inc.
Total of Order $____________
X_______________________________ X____________________
Signature of cardholder * date
*Signature is required to process the order
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