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FAX
/ MAIL ORDER FORM "Please Print Out
Form" We Accept Credit Cards,
Money Orders or Checks
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Product
Selections
Please
print as clearly as possible. If more space is needed,
please attach a additional pages.
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| Quantity |
Item
Number |
Description |
Price |
Total |
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| Please note: For personal check, please
allow up to 7 additional days for funds to clear.
***Make checks payable to:
Michele Molinaro*** |
SUB TOTAL_________________
SHIPPING Included_________________
TOTAL
PRICE_________________
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***Please make check or
money order payable to:
Michele Molinaro***
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Shipping
Information
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Ship To Name: |
| Street: |
| City: |
State: |
Zip: |
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Phone: |
Email: |
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Hawaii, Alaska,
P.R., Canada, APO and 2 or 3 Day Deliveries
will be charged additional
charges.
Please call us for rates -
Payment
Information
For
Credit Card Orders, please complete the Information below
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| Name
On Credit Card: |
| Billing
Address: |
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City: |
State: |
Zip: |
| Phone: |
| Credit
Card Type (Circle One): Visa / MasterCard / Amex / Discover |
| Card
Number: |
| Expiration
Date (mm/yy):
CVV: |
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Cardholder Signature
_____________________________________Date_________________
By signing above, you
authorize Net2Fitness.com/The Fitness Store to charge your credit card for
the amount above. |
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Mailing Address
Michele Molinaro
5101 Oyster Cove
New Port Richey, FL. 34652
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or fax your
order to
FAX: 727-236-9426
anytime, day
or night. |
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