|
Print out this form,
complete it and mail or fax to:
The Pepper Posse
PO Box 6438
2200 Market St
Wheeling, WV 26003
Phone: (304) 233-2330 or (304) 233-1285
Fax: (304) 233-1285
If Using a credit card,
please provide the BILLING address for the credit card so that it can be
securely charged with your information.
| Name: |
| Billing Address: |
| City/State/Zip: |
| Shipping Address if different from billing: |
| City/State/Zip: |
| Phone
(w/ area code): |
| E-mail Address: |
PAYMENT BY:
____Check ____Money Order_____Visa ____ Mastercard_____ Discover
-Make checks or money orders payable to The Pepper Posse
Credit Card Number: __________________________________
Expiration date: ____/____
Name as it appears on Card: ____________________________
Signature:____________________________________________
I would like to
order the following items:
** WEST VIRGINIA RESIDENTS PLEASE ADD 6% SALES TAX **
| Quantity |
Description - Include colors if applicable |
Price |
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
Subtotal |
|
|
Shipping *
|
|
|
West Virginia residents please add 6% sales tax
|
|
|
Total
|
|
|
