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A&E
DESIGNS |
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289 Stuyvesant Ave |
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Lyndhurst, NJ 07071 |
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| Customer
Name
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| Address
_________________________________________ |
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| Apt
or Suite #
_________________________________________ |
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| City,
State ZIP
______________________________
_______ __________-________ |
| Phone ( )
______ - ___________ |
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| Email
address
_________________________________________ |
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| Item # |
Quantity |
Description |
Size |
Color |
Price Each |
TOTAL |
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Coupon Discount (if any) |
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SUBTOTAL
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SHIPPING & HANDLING |
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(1-3 items add $6.50) |
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(3-6 items add $8.50) |
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(6-10 items or more add $12.50) |
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(11 or more items,
please contact us for shipping quote) |
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TOTAL |
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Check or money order payable to
A&E Designs |
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Credit Card (circle one) Visa Discover Mastercard Am. Express |
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| Card
#
____________________________________
expires _____/________ |
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| Signature ____________________________________ Date ________________ |
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You may fax your order to (201) 531-0518 |
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Please direct all inquiries to
info@buycoolshirts.com
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