Its A Black Thang.com Layaway Order Form - Minimum order is
$300
Print this form then click the "Buy Me" button beneath the items
you want to purchase and enter the info on the form. Use shipping chart to determine shipping amount.
Divide order total by three and enter the 1st payment amount and date in the
space provided. (We will enter the 2nd & 3rd payment info.) You can pay by
money order, check, credit card, or debit card.
| Item Number | Qty | Description | Price | Total |
| $300.01 to $400 shipping = $28.50 $500.01 to $600 shipping = $34.50 | Sub-Total: $ |
| $400.01 to $500 shipping = $31.50 $500.01 to $750 shipping = $37 | Processing Fee: $ 20 |
| for orders over $750 the shipping is free | Shipping & Handling: $ |
| 1st pmt date & amount __________________ 2nd __________________ 3rd __________________ | Total: $ |
| Billing
Information: Name: _____________________________________ Address: ___________________________________ City: _______________________________________ State: ____________________ Zip: ___________ Phone: ___________________ Fax: ______________ Email:______________________________________ |
Shipping
Information: (if different than billing) Name: _____________________________________ Address: ___________________________________ City: _______________________________________ State: ____________________ Zip: ___________ Phone: ___________________ Fax: ______________ Email:___________________________________ |
| Method of Payment: [ ]
Check [ ] Money Order [ ] Visa [ ] MasterCard [ ] American Express [ ] Discover Credit Card Num: |
Make check/money order
payable to: Kanes Publications Mail to Kanes Publications P.O. Box 1206 Valrico, FL 33595
|