Sally Stanton Total Fitness 1143 W Memory Lane Santa Ana, CA 92706 Newport Beach, CA 92659-1309 |
Orange County, CA: 714-550-0668 Toll Free: 888-890-8044 Fax: 714-543-6621 Email: [email protected] |
Ship to: | Bill to (if different): |
Name: | |
Address: | |
City, St, Zip: | |
Phones: | |
Email/Fax: | |
Signature | |
New Customer | Returning Customer |
Payment Method | card # | ()Visa | ()M/C | check # |
Exp. Date: month______year_______ | ||||
Signature Cardholder | ||||
Checks payable to: Sally Stanton Total Fitness |
Item Name | Description & Instructions | Qnty | Price | Total |
Subtotal | ||||
Please leave shipping amount blank if ordering more than
2 items
|
Shipping: $6.00 | |||
CA residents only: add 7.75% tax | ||||
TOTAL | $ |
OD:_________Rvd:___Sce:_________ SD:____________Via:____________