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Home
YourHaloBrace
T-Shirts
Sweatshirts
Tank Tops
Children
Contact Us
About Us
Order Form
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Please print out this form, fill it out, then
e-mail, call, fax or mail it directly to us - thanks.
| Print Full Name |
For Fastest Service |
| Address |
CALL 602 - 997 - 4663 |
| City
State
Zip |
FAX 602 - 997
- 1028 |
| Daytime Phone |
E-mail
halowear@aol.com |
| Evening Phone |
|
| Shipping Instructions, if
different |
Please make checks payable to
Marlene Hoffert |
| Name |
Please charge to my |
| Address |
c
VISA
c MasterCard |
| City
State
Zip |
Card number |
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Exp.date |
| Color |
Size |
Description |
Quantity |
Price |
Total Price |
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| What
brand of halo have you? |
Total for
Merchandise |
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| Shipping and
Handling |
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| How did
you hear of our product? |
Sales Tax |
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| TOTAL AMOUNT
ENCLOSED |
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Sizing Information |
| Small |
Chest 28" - 34" |
| Medium |
Chest 34" - 38" |
| Large/XL |
Chest 38" plus |
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| Shipping/Handling
Charges |
| Order Total |
Surface |
2-Day Express |
| Up to $30 |
$7.50 |
$15.00 |
| $30.01-$60.00 |
$9.50 |
$17.00 |
| $60.01-$90.00 |
$10.50 |
$19.00 |
| Over $90.00 |
$12.00 |
$23.00 |
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| Sales Tax is charged on
total merchandise delivered within the state of Arizona |
| Shipping and handling
charges are not refunded on returned merchandise |
| Mail to |
| HaloWear |
| 8410A North Central Avenue |
| Phoenix AZ 85020 |
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