Product Order Form

FAX - IMMEDIATE PROCESSING & FASTEST MOST SECURE WAY TO ORDER OR MAIL YOUR ORDER IN.

FAX: 1-800-930-5402)

MAIL: Healing Wings Bookstore

PO Box 8525

Gadsden, AL 35902

NAME

 

ADDRESS

 

CITY                                                                                               STATE

ZIP

TELEPHONE (Required)

 

QTY

ITEM (CD NAME - BOOK NAME - 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

 

All CD's Free Shipping

0.00

Shipping - All other items

 

TOTAL

 

Name on Credit/Debit Card

Card Type:  __Visa  __MC   Card Number:

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

Signature:

EMAIL:(required)

**Shipping address required if different than above. (Separate sheet of paper) ALL INFORMATION ON FAX ORDERS MUST BE COMPLETED (Phone and email required for contact if we have problem with order. We will confirm by email receipt of order and shipping date.)