Your name___________________________________
Shipping Address:
Street ______________________________________

City, State, Zip_______________________________

Daytime Phone (_____) ________________________

Email______________________________________

Today's Date: ___________________


DATE NEEDED BY _____ / _____ / _____

PERSONALIZED
ITEM NAME:________________________________

ARE YOU ON THE MAILING LIST: Y____ N____
ARE YOU AN INSTRUCTOR?: Y____ N____
JAZZERCISER?: Y____ N____

INVOICE # ____________________
ITEM
COLOR
SIZE
QTY
FULL
THONG
UT
PRICE
PRICE
SHIPPED
               


             


             


             


             


             
               
               


CASH___ CHECK ___ CREDIT CARD___

Mastercard________ Visa _______

CREDIT CARD #____________________________

Expiration
date: ____ / ____ / ____ CVV2 Code*:____
*3 digits in signature strip on back of card to the right of the (partial) card number.

Card name:

Shipping/ Handling
Orders under $25.00__$5.95
$25.01 to $45.00_____$8.95
$45.01 to $65.00_____$11.95
$65.01 to $90.00_____$14.95
$90.01 to $125.00____$17.95
$125.01 to $175.00___$20.95
$175.01 and over: 12% of total

RUSH shipping available
Call for rates



Sub Total: $___________

Sales Tax $___________

Shipping $___________

COD______$7.50_____

Amount due:
Prices subject to change. Click here for the All That Glitters return policy.
All That Glitters • 12303 Eugene's Prospect Drive, Bowie, MD 20720 •
Office Hours 10-5 daily (Eastern) 301-648-7859