Shipping Address:
Name __________________________________________
Address _________________________________________
City __________________, State ________ Zip ________
Telephone ______________ Email ___________________
Quantity:
Product Name:
Price:
1._____
______________________________
_________
2._____
______________________________
_________
3._____
______________________________
_________
4._____
______________________________
_________
5._____
______________________________
_________
6._____
______________________________
_________
7._____
______________________________
_________
8._____
______________________________
_________
Subtotal :
_________
Shipping ($5.99 or free for orders above $50): _________
Total :
_________
* We select the fastest shipping method depending on your order.
Please allow 2-5 business days for processing your order after receiving this form.
You can pay by credit card or send a check or money order.
( ) Payment Option 1. Credit Card (Visa, MasterCard, AmEx, Discover):
Card Type _________________ Expiration Date _________
Card Number _____________________________________
Signature _________________________________________
Name __________________________________________
(as it appears on the card)
( ) Payment Option 2. Check or Money Order
Send us a check or money order payable to Dymecs LLC and mail it to:
Dymecs LLC, 5507-10 Nesconset Hwy. Suite 341, Mt Sinai, NY 11766
The Check or money order must be in US dollars. Orders will be shipped as soon as the check has cleared.
Order Form Checklist:
1. Make sure you have completely filled out the order form.
2. Make sure you have completed your payment information.
3. If paying with Credit Card you can fax the form to Fax: 212-214-0876 or mail it to the address above.
4. If paying with Check or Money Order mail the form to the address above.
Email us at info@horoscopestore.com if you have any questions or if you would like to check the status of your order.