Brigitewear   Order Form

For FAX or Mail Orders Print this form and Fax to number below.  For payment by Check, Money Order or Credit Card Print the form and Mail to Address below:

 

Name:

   Shipping Address: (same leave blank):

 

(Billing) Address:

Payment Type:
Address 2:  

__ Check

  
City:  

__ Money Order
State:  

__ Credit Card (number):

  
Zip:  

Exp. Date ___________

  
Phone:  

Code on Back _______
Email:  

Signature:
Additional info:  

 
Order Information   Color Top Size Bottom Size 1 Pc. Size Price:
Product Name(s):            
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
       

Tax (CA only) 8.5%

  $
         

Sub Total:

  $

Shipping Information:  (Note: Free Shipping applicable for orders OVER $100 US Only)

Free Shipping:  USPS First Class (allow 8-12 days for receipt US orders)  $Free

Standard Shipping: USPS First Class (allow 5-8 days for receipt US orders)  $3.95

Priority Shipping  USPS Priority (allow 2-4 business days for receipt US orders)  $9.98

Rush Shipping  USPS Express Mail (allow 1-2 days for receipt US orders)  $29.95

(International Orders see "Shipping" on Home Page, fill in type/$Amt on right)

  

Shipping Cost:

  $
 

Order Total

 $
Fax (credit card only)  FAX  (800) 757 7990  or Mail Order to:

Brigitewear International     75-161 Sego Lane,  Ste F-15,   Palm Desert, CA 92211

Visa MasterCard Discover American Express and PayPal accepted    Click to open call me page   or  Phone:  (800) 757 2550  or FAX: (800) 757 7990