Midsummer Fairies Order Form

Midsummer Fairies
Toll Free 1-866-44-FAIRY
Fax 1-661-715-1645
4306 West Avenue L
Quartz Hill, California 93536

Name:____________________

Address:___________________
__________________________
City:______________________

State:______________________

Phone:_____________________

Shipping Address

Billing Address (if different)

Payment Method:

Money Order

Visa

Mastercard

Discover

Item #

Description

Price

Qty

Total

SUBTOTAL

TAX

(CA residents add 8.25%)

SHIPPING

TOTAL

(All Orders Shipped US Mail Or UPS Ground)

$0 - $25.00 = $8.95
$25.01 - $44.99 = $10.95
$45.00 - $74.99 = $11.95
$75.00 - $99.99 = $12.95
All Orders Over $100 - FREE Shipping

SHIPPING RATES

Credit Card #___________________________

Expiration Date__________

Email_________________________

Name On Credit Card________________Signature___________________

American Express