| Dreamy Days Gift Boutique Order Form (click here to download form) MAIL TO: 3418-B Hwy 6 S #341 Houston, Texas 77082 281-575-9412 |
Order Date: _____________ First Name ___________________________ LastName_______________________________
Billing Address________________________________________________________________________________________
City: ____________________________ State: ______________ zip: ________________ Phone:______________________
Ship to First Name ____________________________________ Last Name ______________________________________
Shipping Address _____________________________________________________________________________________
City: ___________________________ State: ______________ zip: _________________ Phone:______________________
Credit Card# _________________________________________________________ Card exp date ____________________
Name as on card: _________________________________________ CID Code *__________________________________
|
Item Name |
Qty |
Description |
Color/Size |
unit Cost |
Total Cost |
| Special instructions: Sub Total - This Order |
$ |
|
Add 8.25% if shipped to a Texas address |
$ |
|
Shipping Cost |
$ 10.00 |
|
Total Order |
$ |
* 3 digit code on back of most credit cards or 4 digit code on front of AMEX card.