MJlouis.com Secure Order Form
We ship to every country and territory.
* - these fields are required
Name:*

Email:*
Daytime Phone:*

Fax:
Address to be shipped to:
If you would like the invoice sent to a separate address,
please note the address in the comments box below.

Ship to:*



City:*

State/Territory*:
If APO, APO Info:

Zip/Postal Code:*

Shipping Method:

Standard Delivery (normally ground UPS, can take up to 10 days)

Second Day Air - required for Alaska, Hawaii, and U.S. Territories.
(UPS's 2nd Day Air normally takes 2-3 business days. If checked - you agree to pay the additional costs for faster shipping)

*Please e-mail for overseas shipping rates.

Please enter the quantity, description and price of each item below.
If you would like, we can enter the price.
Qty Description/Item No./$ Ea. - Example Sub tot.
2 #SA2 Ivory Wedding Albums $34.00(sample only) 68.00
1 #WB1 White Wedding Album $54.00 (sample only) 54.00
2 #BF1 Asst.fl.Broc - $54.00 (sample only) 108.00
6 #SO1 Fl. Sachet Pillow $30.00 (sample only) 180.00
Qty Description/Item No./$ Ea. Sub Tot.
                                            NY state res. add 8.25% tax
                                                Shipping/Add $2 per item
                                                           Grand Total
If you need more room, just submit a second page
and note in the comments section below that the order is continued.
Backorders:
It is rare but sometimes we are out of products. If we are out of stock on an item, how would you like us to handle it?
Please backorder any out-of-stock items.
Please cancel any backorders and adjust my total.
Please contact me regarding any out-of-stock items.
Method of payment:
MasterCard Visa Discover Check/Money Order

If Payment is by credit card:
My credit card information is listed to the right
I will call and leave my credit card number at your message phone - (516) 539-9631
I will fax you my credit card number - (516) 539-9631
I will mail you my credit card number.

Note: We will ship within 1-2 weeks, Monday through Friday.
(if we're unable to do so, we'll notify you as soon as possible)

Credit Card Information:
Name

Card Number Expires

Billing address of credit card*


City, State ZIP

* This is the address your credit card company sends your bill to (not your credit card company's address). We need this for charge verification.

Any other comments or questions?
(Special shipping instructions? Product suggestions?)



669 Beck St.
Uniondale, NY 11553
fax: 516-539-9631 email: MJlouis@aol.com
See our return policy at: www.mjlouis.com