Caprice at Resorts FAX Order Form

To order, please print this form, clearly fill out the information below and fax it to us at:
(609) 345-7862 
ITEM(S) TO ORDER
								  
_________________________________________________________________________
(Manufacturer)          (Description)                     (Item #)
				
________________________________________________________________________
(Manufacturer)          (Description)                     (Item #)
				
_________________________________________________________________________
(Manufacturer)          (Description)                     (Item #)
				
_________________________________________________________________________
(Manufacturer)          (Description)                     (Item #)



PERSONAL INFORMATION

Name: _____________________________________ E-mail: ______________________
      (Exactly as it appears on Credit Card)

Address: _________________________________________________________________

City: ______________________________  State: ______  Zip Code: ___________

Phone #: ___________________________                              



PAYMENT INFORMATION

Credit Card Type: VISA  MasterCard    Discover

Credit Card #: _______________________________________ Exp. Date: ____/____

Signature: _________________________________________

Our staff will contact you at the telephone number listed above
to confirm your information and answer any questions.
Thank you for your order!

Please use your browser's "Back" button to go back to the previous page.

[ Home Page | Contact Us ]

This web site designed by HyperMedia Solutions International, and maintained by GiftAC.com..
Any questions or problems regarding this site should be directed to the Webmaster.
Material Copyright © 1999 - 2007 GiftAC.com. All rights reserved.