Order Form
Paphanatics, UnLimited,
3319 W. Lincoln Ave., Ste. 103,
Anaheim, CA 92801
Phone: (714) 639-1387
FAX: (714) 639-5124
E-mail:norito1@hotmail.com
ORDERED BY: (mailing address)
Name:________________________________
Address:______________________________
City:_________________________________
State:_______ Zip:_____________________
Country:______________________________
Telephone:____________ Email:___________
PAYMENT
Check: Amount_________
or
Charge: Visa or Mastercard only. (circle one)
Card #:_______________________________
Exp. date:_____________________________
Signature______________________________
Order Date:____________________________
MAILING ADDRESS (if different)
Name:________________________________
Address:______________________________
City:__________________________________
State:_______Zip:______________________
Country:______________________________
Telephone:____________________________
Shipping Instructions:____________________
_______________________________________
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Item |
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In case your choice is sold out may we substitute similar types? YES NO