Mail and Fax In Order Form

The MailboxWorks
Post Office Box 2040
Lynn Haven, FL 32444
www.mailboxworks.com

How to Submit Order Form

Mail this form to the address to the left or Fax this form to (866) 803-7470

Payment Information

We accept all of the major credit cards, including VISA, MasterCard, Discover and American Express. Prepayment is required for all orders. You can e-mail us or call us to get a shipping quote.

Billing Address

Name:
Company:
Street Address:
Street Address 2:
City, State Zip:

,

Phone:

— , ext.

E-mail:

Shipping Address

Name:
Company:
Street Address:
Street Address 2:
City, State Zip:

,

Phone:

– – , ext.

Item #1

Item Number
Options (Color,size, etc.) *
Quantity
Price
Total

Item #2

Item Number
Options (Color,size, etc.) *
Quantity
Price
Total

Item #3

Item Number
Options (Color,size, etc.) *
Quantity
Price
Total

Totals

Subtotal
# Shipping
@ Tax
Total

* Additional options may also be noted in the additional notes section below.
# Call for shipping charges
@ Orders within Illinois will be subject to tax.

 

For fastest processing please enter your credit card information. Please allow extra processing time for check payments.
Select Payment method

Visa
Mastercard
AMEX
Discover
Check

Card Number:
Name On The Card:
Expiration Date:

/

Security Code:

How did you hear about us?

Select One
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I Don’t Know

Additional notes on the order

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