Love Scent Mail Order Form

Love Scent Mail Order Form
Type in your name, address etc; print the form; and write in your order with a pen.

 Name AddressCity State Zip CodeTelephone number Country (Please include your e-mail address so we can notify you when your order has been shipped)Email addressMake money orders/checks payable to "Love Scent Inc" in U.S. dollars. (No Eurochecks) Orders shipped upon arrival if made with a credit card, bank check or money order. Orders made with personal checks (US banks only) may be held until funds clear.Credit Card Orders (Master card, Visa, American Express, Discover):
Note: The card billing address must be the same as the shipping address for verification purposes. Transactions will appear on your credit card bill as </>"MWC"Card holder name  Card number 

Expiration date   Customer signature _______________________

Please mail your order to:

Love Scent
3595 Western Dr.
Eugene, OR 97401


Credit Card orders can also be placed with our toll free order-line: (888) 777-1115   Love Scent Home Page

Items

QUANTITY

COST EACH

TOTAL

       
       
       
       
       
       
SUB TOTAL      
SHIPPING AND HANDLING
INSIDE THE UNITED SATES Only
  $ 4. (regular)
$8. (priority)
$22. (FedEx 2 Day)
 
SHIPPING AND HANDLING
OUTSIDE THE UNITED SATES
  $ 8. (regular)
$24. (priority mail)
$44. (express mail)
 
TOTAL      
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Love Scent Inc.