PinkApple.com Printed Order Form

Instructions
Print this form if you wish to order by Fax or Mail. Make sure your entries are complete and clearly legible so that your order is processed smoothly and your products arrive in a timely manner. Orders can be submitted by faxing to: 614-527-8565, or by mail to:

PinkApple.com
2177 Westbelt Dr.
Columbus, OH 43228

Name and Shipping Information  
Name:___________________________________ Are you a previous customer? (Y/N):_________
Street Address:____________________________  
Street Address 2:____________________________  
City:______________________ State:_________ Zip:__________________
Country:__________________________  
Tel(Day):__________________________ Tel(Evening):_________________________
Email:______________________________  

Your Order:
  Item Name/Description: Quantity: Price:
  __________________________________ ____________ $____________
  __________________________________ ____________ $____________
  __________________________________ ____________ $____________
  __________________________________ ____________ $____________
Shipping and Handling: $____________
Tax (Ohio residents add 6.75%) $____________
Total: $____________
 



Payment Methods

Visa, MC, Discover, AM Ex, Check or Money Order (Payable to PinkApple.com)

Please check one of the following:

Payment by Check / Money Order (Make payable to PinkApple.com and mail to the above address)

Payment by Credit Card - My card information is already on file

Payment by Credit Card - My card information is as follows

Card Number:______________________________ Expiration Date:__________
Name appearing on card:_______________________________________________
Card Billing Address (only if different from above):
Street Address:_____________________________________________________
City, State Zip:_____________________________________________________
I accept the above charge:__________________________________(Signature)
**If you are paying by credit card, you may see a charge to PCPD, LLC. This is the same as PinkApple.com, and is used to ensure your privacy. This is also the label under which we ship all of our packages.

Thank you for your order

Please double-check that your order is complete and legible, especially the shipping address and phone number.

Thanks again for choosing PinkApple.com.
http://www.pinkapple.com/