Retail |
Date:__/__/____ |
Mail this form to: Woodland Candles Inc. P.O. Box 111256 Carrollton, Texas 75011-1256 Or Fax to: 972-325-2011 |
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Scent and Type: |
Quanity: |
Price: |
Total: |
Classic Jar 10 oz. - 7.99 |
|
| Sub Total | |||||
| Shipping Charge | |||||
| Tax = 8.25% (TX only) | |||||
| Total | |||||
| Ship To: | ||
| Name: | ||
| Address: | ||
| City: | State: | Zip: |
| Phone: | Email: | |
| Payment Method | ||
| [ ] Signed Check or Money Order enclosed | ||
| Charge my Debit or Credit Card | ||
| [ ] Master Card [ ] Visa [ ] American Express [ ] Discover | ||
| Credit Card Number: | Exp. Date: __/____ | |
| Signature | ||
| X_____________________________________________________ | ||
| Candle Order Subtotal | Freight Charge | Candle Order Subtotal | Freight Charge |
| $ 0.00 - $20.00 | $8.99 | $200.01 - $250.00 | $23.99 |
| $20.01 - $35.00 | $9.99 | $250.01 - $300.00 | $26.99 |
| $35.01 - $50.00 | $10.99 | $300.01 - $350.00 | $29.99 |
| $50.01 - $75.00 | $12.99 | $350.01 - $400.00 | $32.99 |
| $ 75.01 - $100.00 | $14.99 | $400.01 - $450.00 | $35.99 |
| $100.01 - $150.00 | $17.99 | $450.01 - $500.00 | $38.99 |
| $150.01 - $200.00 | $20.99 | $500.01 and up | $41.99 |