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Complete This Order Form And
Mail With Check Made Payable To:
Complete This Order Form And
Mail With Check Made Payable To:
Marie Adele, LLC
Marie Adele, LLC
Att: SweetHeart Pouch
PO Box 4153
Brick, New Jersey 08723
Att: SweetHeart Pouch
PO Box 4153
Brick, New Jersey 08723
| This Order Form Is For Money Order And Check Orders Only. (Please Place Credit Card And Debit Card Orders On Our Website With Pay Pal) |
| Please Print |
_________________________________________________ ____________________________________________
Last Name First Name
_____________________________________________________________________ ____________
Address Apt.#
______________________________ ____________________________________ ____________
City State Zip Code
__________________ ______________________________________ ______________________
Phone Email Address Fax
Last Name First Name
_____________________________________________________________________ ____________
Address Apt.#
______________________________ ____________________________________ ____________
City State Zip Code
__________________ ______________________________________ ______________________
Phone Email Address Fax
| We will not share any of your personal information. Phone, Fax and Email information will only be used to contact you regarding your order. |
| Please Put Quantity In Space Next To Color Choice Below |
Light Pink___ Light Yellow____ Camo___
Lavender_____ Black_____ Red_____
Emerald Green_____ Light Blue_____
Lavender_____ Black_____ Red_____
Emerald Green_____ Light Blue_____
Total # of SweetHeart Pouches® ordered _____ X $12.00 =
7% Sales Tax For Delivery To New Jersey =
| Shipping & Handling = |
Total Enclosed =
Merchandise Total =
| Subtotal Merchandise + Shipping & Handling = |
| Total # of SweetHeart Pouch® Bears ordered _____ X $39.99 = |
| ® |
| + |
| + |
| SweetHeart Pouch |
| SweetHeart Pouch Teddy Bear |
| = |
| = |
| = |
| + |
$
$
$
$
$
$
$
| Merchandise Total |
Shipping & Handling Charges
| (See Shipping & Handling Chart) |
| Add |
| $6.00 |
| $.01 - $34.99 |
| $7.50 |
| $35.00 - $60.99 |
| $8.75 |
| $61.00 - $79.99 |
| $10.00 |
| $80.00 - $99.99 |
FREE!
| $100.00 or more |
SweetHeart Pouch Teddy Bear
Quantity _____
SweetHeart Pouch Color _________
Quantity _____
SweetHeart Pouch Color _________
®
®
®
| When you purchase a SweetHeart Pouch Teddy Bear, the SweetHeart Pouch is now included. Be sure to list your SweetHeart Pouch color choice when you place your Teddy Bear order. |
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