Embroidery Design Group - "Print and Fax" Order Form
Fax to:614.799.6936

Phone: 614.798.8152



Order date: __________________________
Account/Company name: ___________________________________________
Your name: ___________________________________________
Street Address: ___________________________________________
City: ___________________________________________
State/Zip: ___________________________________________
Phone number: (_______)__________________
E-mail address: ___________________________________________
 
Ship to Name: ___________________________________________
Ship to Street Address: ___________________________________________
Ship to City, State, Zip ___________________________________________
Bill order to (check one): ___ Account | ___ Credit Card | Other _________________
Account # or Credit Card #

________________________ CCV _______ Exp _______

Signature: ___________________________________________
   

Item # Qty. Description Size Item color Imprint color Price each Total
               
               
               
               
               
               
               
               
               
               
               
Shipping & Handling ________
Sales Tax ________
Total ________

Signature: ___________________________________________

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