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Bead House (NY) LLC |
Order Form |
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| 12 Rewe Street |
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Brooklyn, NY 11211 |
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| TEL: 212-714-1420 |
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| FAX this form to: 212-967-5015
or |
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Date: |
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| MAIL this form to above
address, attn: Mail Order Dept. |
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| E-MAIL orders to: beadhouse@aol.com |
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Page#: |
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Minimum order: $15-$20 per style per color, $30.00
total order. |
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| Your name & Company name: |
Address: |
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Telephone & Fax#: |
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| QTY |
UNIT |
STYLE |
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SIZE/COLOR/DESCRIPTION |
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PRICE/unit |
Total |
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| Payment Method |
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| Visa / Mastercard / American Express |
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| Card #: |
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Exp. Date |
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| Signature: |
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Shipping charges additional - Thank
You for your order! |
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