Onlymannequins

34 Summit St Suite B

East orange NJ,07017

Fax (917)464-6515

 

Fax Order Form

Please Fill in all proper information which is found next to each item ( Item Number, Price, Color and Shipping)

 

Item Number

Color

Price

Shipping

  NJ Resident Tax (6.00%)
 
Total

PAYMENT:
If Credit Card is selected please also complete the Credit Card Information section.
 

   
Card Name
Card Number
Expiration Date                         CVV Code

 

Bill To:
First Name
Last Name
Address
City
State
Post Code
Phone
Email
Country
Ship To:
Same as Billing Address
Ship to Name
Address
City
State
Post Code
Country
Order Comments and Special Requests