or FAX to: (813) 975-9131
To order by fax or mail: Print out this form and mail to:
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Bedroom Gallery 2021 E. Fowler Avenue, Tampa, FL 33612 or FAX to: (813) 975-9131 |
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DESCRIPTION |
SIZE | COLOR | PRICE (Ea.) |
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$
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Shipping | FREE |
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Florida Residents Only please include 7 % Sales Tax |
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Sales Tax | $ |
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Please include check or money order or use Credit Card Information below |
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TOTAL | $ |
| Your Name: | _____________________________________________________________________ |
| Address: | _____________________________________________________________________ |
| City: | ___________________________________State:___________Zip Code__________ |
| Phone: | ( ) ________________________________________ |
| _________________________________________________________________ | |
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CreditCard Select One |
(Visa __) (MC __) CARD NUMBER ________-________-________-________ (Disc __) (Amex__) Expiration Date_________________________________ |
______SIGNATURE___________________________________________________