Fax Order Form to Vita Int'l for Universal, Round and Graceful Cradle (412) 732-9030
Shipping Address: Please print clearly.
Name: _________________________________________________
Street: _________________________________________________
City: __________________ State: _________ Zip: ______________
Home Phone #: (______)_________________________________
Daytime Phone #: (______)_________________________________
Event Date: _______________E-mail address for fax confirmation: ________________________________
How did you hear about us? ______________________________________
If different than above... EXACT Billing Address:As is appears on your credit card statement.
Name: _________________________________________________
Street: _________________________________________________
City: __________________ State: _________ Zip: ______________
Credit card number __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Expiration date (month/year) __ __ /__ __ Card Code __ __ __
Number of Bouquet Displays with the UNIVERSAL AND ROUND VITS only _____________
Number of Bouquet Displays with GRACEFUL CRADLE only _____________
Bouquet Display Total @ $8.00 Each __________.___
Number of GRACEFUL CRADLE VIT ATTACHMENTS only _____________
Graceful Cradle Vit Attachment Total @ $2.00 Each __________.___
Regular Shipping $1.00 for Each Bouquet Display only __________.___
(Additional Graceful Cradle Vits ship free with each bouquet display that you order. So only pay for shipping for the number of bouquet displays that you are ordering.
Up to 12.)
Click Here for Priority and Express shipping details.
Priority shipping $4.00 additional __________.___
Express shipping $18.00 additional __________.___
Sub-total __________.___
PA residence only, 7% sales tax to total order __________.___
Total Order __________.___
With regular shipping, you will receive your order within two weeks. THANK YOU!