1-877-NICESUDS
FAX: 1-507-448-2754
 120 E. Main St., Glenville, MN 56036
 

This form has been created
for those of you who do not wish to order online.
Print, fill out, and fax or mail in.

CONTACT & SHIPPING INFORMATION

Name:
Company Name:
Tax Number:
(MN only)
Delivery Address: Residential - Commercial
Street Address:
City:
State/Prov:
Zip/Postal Code:
Phone:
Email:

 
  1. Fax or mail your order; indicating method of payment:
     
  2. check credit card
     
  3. Once your order has been received, shipping will be calculated.
     
  4. You will be contacted with the total amount owing prior to shipping.
CREDIT CARD Visa Mastercard Discover
 American Express
Card Number
Name as appears on card:
Expiration Date
SIGNATURE(Faxing)

PRODUCT ORDER FORM
order all products except scents & molds here

ITEM

##

PRICE

TOTAL


SCENTS & MOLDS ORDER

MOLD & NUMBER / SCENT

OZs

##

PRICE

TOTAL
TOTAL