Fax Order Form to Vita Int'l for Universal Master, Rosemary Round and Graceful Cradle fax (412) 564-9894

 

Shipping Address: Please print clearly.


Name: _________________________________________________


Street: _________________________________________________


City: __________________ State: _________ Zip: ______________


Home Phone    #: (______)_________________________________
Daytime Phone #: (______)_________________________________


Event Date: _______________   

E-mail address for fax confirmation: ________________________________
How did you hear about us? ______________________________________

If different than above... 
EXACT Billing Address: 

As is appears on your credit card statement.


Name: _________________________________________________


Street: _________________________________________________


City: __________________ State: _________ Zip: ______________


Credit card number __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Expiration date (month/year) __ __ /__ __        Card Code __ __ __


Number of Bouquet Displays with the UNIVERSAL AND ROUND VITS only _____________

 

Number of Bouquet Displays with GRACEFUL CRADLE only _____________


Bouquet Display Total @ $8.00 $5.95 Each __________.___

 

Number of GRACEFUL CRADLE VIT ATTACHMENTS only _____________

 

Graceful Cradle Vit Attachment Total @ $2.00 Each __________.___


Regular Shipping $2.75 for the First Bouquet Display __________.___
Regular Shipping $1.06 for Each Additional Display __________.___

 

 (Additional Graceful Cradle Vits ship free with each bouquet display that you order.  So only pay for shipping for the number of bouquet displays that you are ordering.
Up to 12.)
 

Click Here for Priority and Express shipping details.

Priority shipping $4.00 additional __________.___


Express shipping $21.00 additional __________.___


Sub-total __________.___


PA residence only, 7% sales tax to total order __________.___


Total Order __________.___

                    With regular shipping, you will receive your order within two weeks. THANK YOU!

BACK or HOME or ONLINE ORDERING HERE