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The EDUCATED PALATE - Printable Order Form Questions? Email
us at: sales@educatedpalate.com Print this order
form, fill out your merchandise order information and your customer
information below, and mail form along with your check, money order, or
credit card information to:
Customer
Information Customer Name:
___________________________________________ Mailing Address: ____________________________________________ Zip Code:_____________ Telephone:___________________ Email:
___________________ Billing Information (If paying by credit card)
Visa, MC,
Discover, AMEX Name as appears on Credit Card:
____________________________________ Billing Address: ___________________________________________________ Zip Code:_____________ Telephone:___________________ Email:_________________ Signature: ______________________________________( please sign for credit card orders) --------------Please complete this section, for ALL payment types----------------------- check here if shipiing information and addesss is the SAME as above Ship to name: _____________________________________________________ Mailing address:____________________________________________________ City__________________________ State_________________
ZIP__________ Enclosed
is the full amount of my order:
$_______________________________ Paid by:
Personal Check
Money Order
Certified Check
Credit Card -------------------------------------------------------------------------------------------------------------------- Shipping
Charges for United States and Puerto Rico
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