Product Order Form

FAX FOR (IMMEDIATE PROCESSING & FASTEST MOST SECURE WAY TO ORDER) OF YOUR ORDER OR MAIL YOUR ORDER IN.

FAX: 1-256-546-0467

MAIL: HWM

PO Box 4287

Gadsden, AL 35904

NAME

  

ADDRESS

  

CITY                                                                                               STATE

ZIP

TELEPHONE

  

QTY

ITEM (Please give Color - Fragrance - Size etc.)

PRICE

TOTAL
       
       
       
       
       
       

Shipping Rates:  FREE SHIPPING ON ALL CD'S   (The following rates are for all other items.)

From(USD)

To(USD)

Rate(USD)

0.01

15.95

2.25

15.96

49.95

4.95

49.96

89.95

8.95

89.96

169.95

11.95

169.96

and up

14.95

Subtotal

  

Shipping

  

TOTAL

  

Name on Credit/Debit Card

Card Type:  __Visa  __MC   Card Number:

VVC Code (last 3 digits on back of card):

Signature: