Quiet Moments Order Form:
Billing Address:
Name: _________________________________
Address: _______________________________
_______________________________________
Phone: _________________________________
E-Mail:__________________________________
Method of payment:
Check ___________ Money Order __________ Paypal__________
(credit cards are accepted through paypal only– you will be e-mailed account information for payment through paypal.)
Shipping Address:
Basket # 1
Name: _________________________________
Address: _______________________________
_______________________________________
Phone: __________________________ for UPS
Basket # 2
Name: _________________________________
Address: _______________________________
_______________________________________
Phone: __________________________ for UPS
Basket # 3
Name: _________________________________
Address: _______________________________
_______________________________________
Phone: __________________________ for UPS
