Phone 914-662-1220, Fax 914-662-1224, Email: Fayshoes@aol.com
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Postal Code | ______________________ | Call for Wholesale or School Pricing! |
Quantity | Product Description | Unit Price | Extended Price |
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| ____ Credit Card | Sub Total | _________ | |||||||||
____ Gift Certificate | Shipping | _________ | ||||||||||
____ Cash/Check/Money Order | _________ | |||||||||||
Grand Total | _________ |
Credit Card Information
Credit Card Number
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Expiration Date
Security Code
_____/_______ mm/yyyy
__________ Where to find
Name on Card
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