Mail Order Form

    Printable Mail Order Form

Customer Data Sheet To conserve ink, you may want to print this form in greyscale!!! Name: Email: Street: City: State: ZIP: Phone:
Ordering Information Note: You can type in as many words as you like in the "Item Description" box...
Item # & Style	Quantity	Price Per Item	Total Price
	Shipping:
	Sub Total:
	Sales Tax: (WA residents only) Please add 8.2%
	TOTAL:
Shipping Options: U.S.P.S. Priority Mail (2-3 day) - $5.00 Delivery Confirmation (U.S. Orders Only) - Add .50 cents Insurance (U.S. Orders Only) - Add $1.30 International Orders - $8.00 Orders Over $50.00 Free Shipping
Credit Card Payments               Type of card Visa Master Card Name on card Card number Expiration date Click here to "sign" the Credit Card Voucher
To pay by check or money order, please mail this printable form to: MAXIMUMEYEWEAR.COM P.O.Box 227 Satsop WA 98583 Questions? Send Us A Message:
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