BUYERS NAME:______________________________________
BUYERS ADDRESS______________________________________
BUYERS PHONE NUMBER________________________________
ITEM#_______________ QUANTITY__________ PRICE_________SIZE_______
ITEM#_______________ QUANTITY__________ PRICE_________SIZE_______
ITEM#_______________ QUANTITY__________ PRICE_________SIZE_______
ITEM#_______________ QUANTITY__________ PRICE_________SIZE_______
NAME, ADDRESS, ARE NOT OPTIONAL. PHONE NUMBER IS OPTIONAL BUT CONTACT WILL BE EASIER AND TAKE LESS TIME IF CONTACT IS NEEDED. IF YOU WOULD LIKE TO TO COMBINE ALL YOUR PURCHASE PRICES ON 1 CHECK OR MONEY ORDER THAT WILL BE ACCEPTABLE. IF YOU WOULD LIKE ANY ITEM TO BE SHIPPED TO A DIFFERENT ADDRESS THAN THE ONE LISTED FOR BUYER, FILL OUT THIS PART:
SHIPPING ADDRESS ________________________________________
NAME TO BE SHIPPED TO __________________________________
IF YOU WOULD LIKE ANY CORRESPONDENCE INCLUDED, WE WILL BE HAPPY TO ACCOMMODATE YOUR REQUEST, JUST MAIL IT IN WITH THIS FORM. SHIPPING WILL BE DISCREET AND WILL ONLY INCLUDE OUR PO BOX.
CHECK ONE PAYMENT TYPE
MONEY ORDER____________ PERSONAL CHECK_____________
TOTAL AMOUNT ENCLOSED US$_______________________________
PLEASE MAKES CHECKS AND MONEY ORDERS PAYABLE TO:
EMBERTON
PO BOX 1968
HARDWICK, GA
31034
We reserve the right to update model designs or substitute models or colors whenever these changes represent an equal or better value for our customers.