On-The-Spot Embroidery Order Form
Use this form when Mailing in your Personal Check or Money Order.
You may also use this with Credit Cards.

 

 

 

 

Date

 

 

 

Shipping Address

 

 

Name

 

 

Address

 

City

State

Zip Code

 

 

Telephone #

area code ( )

 

 

 

Billing Address Same as Above

 

Name

 

Address

 

 

 

City

 

 

State

 

 

Zip Code

 

 

Telephone #

area code ( )

 

 


Item Number

Color

Size

Qty

Product

Total

 

 

 

 

Subtotal

TOTAL ORDER

SHIPPING

$0.00-50.00

$

50.01-75.00

$

75.00 and up

$


You may fill this form out online and print it from your browser and mail it in, or you may print the form blank and fill it in at your convenience.

Sales Tax

Shipping Charges

 

 

Total

Method of Payment ( Check all that apply)

 

 

 

 

Personal Check or Money Order

 

Credit Card

 

 

 

Visa Mastercard

Credit Card Number

 

 

Expiration Date

Signature

 

Mail in with Payment (Check/Money Order) to:

On-The-Spot Embroidery
301 Bellingrath Terrace
Deland, Fl 32724-7319
Phone: 386-740-2427
Cell: 937-554-2027

 

 

 

If you have any questions, please call us at: 386-740-2427