Copy this form and fax your order to: Cindy's Charms 310-807-9262

Name__________________________________________________________________________
Company Name__________________________________________________________________
Billing Address_______________________________________________________________
City_____________________________State_______________Zip code_________________
Email Address_________________________________________________________________
Fax___________________________________________________________________________
Shipping Address(if different then billing address)
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Would you like to receive your order confirmation by email_____or fax_____?

Payment: Visa_____ Mastercard _____
Credit Card # ________________________________________________________________
CID# (the last 3 numbers on the back of your card)____________________________
Signature_____________________________________________________________________
Paypal_____ - Paypal email address ___________________________________________
If you choose Paypal an invoice will be sent to you from Paypal. ________________________________________________________________________________
ORDER
SKU # or Item Name_______________________________Price______Quantity_________
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If you need additional space use additional paper...Thank you!