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American Made Shop, LLC. Mail/Fax Order Form
Print out this page, fill in the details and fax to (877) 663-3438
or Mail to: American Made Shop, PO Box 252157 St. Louis MO 63125
To check the status of an order already placed, please call:
(877) 663-3438 Toll Free US / Canada.
Credit Card Billing Address


NAME/TITLE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

COMPANY NAME. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ADDRESS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CITY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

STATE . . . . . . . . .. . . . . . . . . . . . ZIP. . . . . . . . . . . . . . . . . . . .

PHONE . . . . . . . . . . . . . . . . . . . . . . FAX. . . . . . . . . . . . . . . . .

E-MAIL ADDRESS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ship To Address ( needed if different from billing )


COMPANY NAME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ATTN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ADDRESS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

STATE . . . . . . . . . . . . . . . . . . . . . . . . . ZIP. . . . . . . . . . . . .

SPECIAL HANDLING INSTRUCTIONS . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Order Information - Item Name / Description

Quantity

x Unit Price

=Total Price

       
       
       
       
       
SIGNATURE X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .DATE. . . . . . . . . . . . . . . . . . . . .
Shipping Options
Please see our page for pricing www.bodyworx.com/shipping.html
International / Wholesale orders please contact us for shipping fee quotes
Method of Payment

To speed your order, please include check, account, or credit card information.

Check enclosed (U.S. ONLY)

Credit Card - Visa / MC ONLY
Account #
___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___
Exp. Date:______/______    3 digit CVV2 Code ___|___|___ on back of card
FAX to (877) 663-3438

Sub Total

$______________

Shipping

$______________
TOTAL $______________

Mailing Address:
American Made Shop, LLC.
P.O. Box 252157
St Louis, MO 63125

NOTE: Orders paid check will be held until funds have cleared, guaranteed funds will be processed and shipped the following business day.
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