Leeleeko Jewelry Wholesale Order Form
Print form out and fax.
Contact us for fax information.
Other file formats of this form
orderform.pdf or
orderform.dot
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Ordered By: Name |
Address |
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Company |
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Phone |
City, State ZIP |
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Check Enclosed |
Card Type VISA/MC/DISCOVER |
Credit Card Number |
Name on Card |
Expiration Date |
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Item No. |
DESCRIPTION |
UNIT PRICE |
Qty |
TOTAL |
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1) Wholesale Only - $200 minimum order. 2) Call for other available styles or special orders. |
TOTAL PG 1 |
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| TOTAL PG 2 | ||||
| TOTAL PG3 | ||||
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SHIPPING & HANDLING |
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TOTAL |
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Vendor ID # |
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Authorized by Date |