URSULA'S COSTUMES

Fax/Mail Order Form
 Print out this page and fill it in as you browse the site,  Then fax it to (310) 582-8233
Please be sure to print legibly and check your order for accuracy.
Shipping Information
Name  
Street Address  
City, State, Zip, Country  
Phone Number  
E-mail Address  
Order Information
Item Number Description Size Quantity Unit Price Total
           
           
           
           
           
           
           
           
           
           

Sub-Total:  

  
If you are a California Resident, please calculate 8.25% sales tax    
* Shipping Charge: (Please check the chart below for the proper amount to add)    
(Please pay this amount) GRAND TOTAL:    
Credit Card Information
Check one   American Express   Discover Card   MasterCard   Visa
Name on Card:  
Credit Card Number:  
Expiration Date:  
Security ID:  
Signature:  
  ALL SALES ARE FINAL / NO EXCHANGES / NO RETURNS


Domestic Shipping Chart

If your Sub-Total is less than or up to $20.00, add $10.00
If your Sub-Total is between $20.01 to $40.00, add $11.00
If your Sub-Total is between $40.01 to $60.00, add $12.00
If your Sub-Total is between $60.01 to $80.00, add $13.00
If your Sub-Total is between $80.01 to $100.00, add $14.00
If your Sub-Total is more than $100.00, add $15.00
Each additional $100.00, add $6.00
For Hawaii and Alaska, add additional $14.00

PLEASE PRINT THIS PAGE AND MAKE SURE THAT THERE ARE NO BLANK FIELDS BEFORE SENDING.

PLEASE FAX ORDERS TO: (310) 582-8233

* IF MAILING A MONEY ORDER OR CASHIER'S CHECK 
PLEASE MAKE IT PAYABLE  TO "URSULA'S COSTUMES"

OUR MAILING ADDRESS IS:

Ursula's Costumes Inc.
2516 Wilshire Blvd.
Santa Monica, CA 90403

Phone # (310) 582-8230

* (Please allow one to two weeks to receive your order.)

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