To order our products, please submit the below order form to: Essentials For The Special Woman 54 Hartford Turnpike Vernon, CT 06066 Phone: 860.647.6996; Fax: 860.646.8900 Email: essentialfor@sbcglobal.net
Name:
Address:
City/State/Zip:
Phone:
Fax:
Email Address:
Item #
Quantity
Item Description (Include Size/Color Options)
Item Price
Total Price
Subtotal
Shipping
CT Residents add 6% Tax
Total
Purchase Amount
USPS Shipping Rate
$0.01 - $9.99
$5.95
$10.00 - $19.99
$7.95
$20.00 - $39.99
$8.95
$40.00 - $59.99
$9.95
$60.00 - $79.99
$10.95
$80.00 - $99.99
$11.95
For all orders over $100
Add an additional $1.00 per each $20.00 worth of purchases
Payment being made via: Check ______ Visa ______ MasterCard ______