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Order Form

Prairie Road Designs is a company located in Wentzville, Missouri that sells home goods and provides an order form for customers to place orders. The order form requests the customer's name, billing/shipping addresses, phone number, email, items and quantities being ordered, payment type (Visa, MasterCard, American Express or Discover), credit card number and expiration date. The customer signs and dates the bottom of the form to complete the order.

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Prairie Road Designs
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
60 views

Order Form

Prairie Road Designs is a company located in Wentzville, Missouri that sells home goods and provides an order form for customers to place orders. The order form requests the customer's name, billing/shipping addresses, phone number, email, items and quantities being ordered, payment type (Visa, MasterCard, American Express or Discover), credit card number and expiration date. The customer signs and dates the bottom of the form to complete the order.

Uploaded by

Prairie Road Designs
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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PRAIRIE ROAD DESIGNS

2818 South Point Prairie Rd


Wentzville, MO 63385
e-mail: [email protected]
www.prairieroaddesigns.com
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Thank you so much for your interest in Prairie Road Designs. Please use this form to place your order and don’t forget to tell your friends about
us!

ORDER FORM

NAME:_______________________________ NAME:__________________________________

BILLING ADDRESS:____________________ SHIPPING ADDRESS:______________________

_____________________________________ ________________________________________

_____________________________________ ________________________________________

PHONE #:____________________________ EMAIL:__________________________________

QUANTITY DESCRIPTION PRICE TOTAL

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

_____________________________________________________________________________________

PAYMENT TYPE SUB-TOTAL:________

____VISA 5.9% MO SALES TAX (IF APPLICABLE):________

____MASTERCARD TOTAL:________

____AMERICAN EXPRESS

____DISCOVER

CREDIT CARD NUMBER:________________________________________ EXP:_________

SIGNATURE______________________________ DATE________________________________

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