shopping at www.jaceywyatt.com

	Ordered by:
First Name:
Last Name:
Address:
Apt, Suite:
City:	State: Zip Code:
Phone Number:
Email:
	Ship to: check box if shipping address is same as billing address. We DON'T ship to P.O Box numbers.
First Name:
Last Name:
Address:
Apt, Suite:
City:	State: Zip Code:
Phone Number:	*NUMBER IS REQUIRED FOR SHIPPING - ORDER WILL BE DELAYED IF MISSING
	add a gift message: *REQUIRED

Product Name / Code	Quantity	Product Description	Price Each	Total Amount
		Jacey Wyatt® Body Glove Swimwear Poster 11"x17"	$15.00

Credit Card:	Visa MasterCard Discover Card American Express
Name on Card:
Credit Card Number:
Exp. Date:
Street Address Card is billed to:
Zip Code Credit Card is billed to:

Fedex Ground/USPS	Ground Service	Second Day Service	Next Day Service
If your total is:	3 to 8 business days	2 business days (by 5 p.m.)*	Next day by 5 p.m.*
Up to $25.00	$7.95
$25.01 - $50.00	$9.95
$50.01 - $100.00	$12.95
$100.01 - $150.00	$16.95
$150.01 - $200.00	$19.95
$Over $200.00	Call for rates.	Call for rates.	Call for rates.
*Most areas. All shipping costs are estimated here. Actual amount will be on Invoice with customer notification.
All rates apply to the 48 contiguous U.S. states only. Call for AK, HI, PR. Orders ship Monday through Friday; signature required for most deliveries. All prices subject to change without notice. For Saturday rates delivery at $15 extra charge is applied to account, Questions and information please call 203-481-0001