Fax Order Form


Fantasyland Costume Co.
Fax:(888) 557-1883
Please be sure to read the Terms and Conditions Page BEFORE faxing this form

NAME: ________________________________________________________
Home Phone: ________________________________________________________
Daytime Phone: ________________________________________________________  
Fax: ________________________________________________________  
E-Mail: ________________________________________________________  
Street Address: ________________________________________________________  
City: ________________________________________________________  
State: ________________________________________________________
Zip CODE: ________________________________________________________
Method of Payment:      Check        Credit Card        Money Order  Check #:________________Allow 2-3 weeks to clear
Credit Card #: ____________________________ Circle One: Master Card  Visa  AMEX   Discover
Iss. Bank: ____________________________ Expiration Date:____________________CVC Security Code____________________
  Description Stock# Size Color# Color# QTY Price Each Sub Total
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Shipping:  

Total:

 

I do hereby authorize the above charges on my credit card. Sig:______________________________________________________

Prices subject to change without notice.

Your IP Address is: 23.20.242.166
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