Fax Order Form
Fax Order Form
J. R. Willey Company, Inc.
Bronze Artworks
Date ________________
FAX TO: 650-312-8710
| Model Number | Item Description | Quantity | Price Each |
Total |
Total ___________
CA Residents add 8 % Sales Tax ___________
Standard Shipping FREE
Total Due ___________
Name __________________________ e-mail ____________________
Address ______________________________ phone ( optional) __________________
City ______________________________ State _________ Zip ____________
Credit Card: Type ____________ Number ________________________ EXP ________
Comments ___________________________________________________________________
FAX TO 650-312-8710