Fax Order Form

 To: 802-609-2332

 
 

Kaviik’s Accents
 

 

 


 

Order Details:
 
 

 


Item #

Description

Qty

Unit Price

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter Free Shipping Coupon (if any)

Coupon Code: ___________________

Sale is Final with Free Shipping Coupon, Subject to Terms of Sale, Free Shipping Orders will be shipped via standard ground service only.

Sub-Total

 

 

Shipping

 

 

Order Total

 

 
 
                      

 

Ship To:
 

I hereby confirm this order as detailed and agree to the terms of sale as posted on www.kaccents.com.  I authorize Kaviik’s Accents to charge this order to my credit card given above.

 

 

 

 

Customer / Cardholder Signature: ___________________________________
 

Thank you for shopping at www.kaccents.com
 

  CHECK & MONEY ORDER PAYMENTS

  MAIL TO:

  Accent Commerce Solutions

  P.O. Box 802

  Milltown, NJ 08850
 

COMPLETE DETAILS FOR CREDIT CARD PAYMENTS:

 

Credit Card Type   : Visa (   ) MasterCard (   ) Amex (  )

Credit Card No.     : _____________________________

Cardholder Name  : _____________________________

Expiration Date     : _____________________________

CVV2 Number      : _____________________________

 
 

Bill To:    (   )   If same as shipping address
 

First Name: __________________________________

Last Name: __________________________________

Address     : __________________________________

City, State, Zip: ________________________________

Telephone: __________________________________

Email         : __________________________________

 
 

First Name: ________________________________

Last Name: ________________________________

Address     : ________________________________

City, State, Zip: _____________________________

Telephone: ________________________________

Email         : ________________________________

 

 
 

Payment Method:

Please check one
 

  Check (    )    Money Order (    )     Credit Card (    )