BelilahOnline Printable Order Form
(Use the "Print" function in your browser)
Customer Information: (please print)
Name: ___________________________________________________________
Shipping Address: __________________________________________________
City, State, Zip: ____________________________________________________
e-mail address: ____________________________________________________
| Item
Number |
Item
Name |
Notes (color, measurements etc. when applicable) |
Price
Each |
Quantity | Total
Price |
| Subtotal
|
|||||
|
Shipping (see the Shipping
Terms page) |
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| Total
|
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Checks or Money Orders should be payable to BelilahOnline and should be mailed to:
BelilahOnline.com
P.O. Box 281
Lexington AL 35648