Printable Order Form

Print this Order Form, fill it out, and mail it to Mike Ambroise.
Mike Ambroise
P.O. Box 742
Brockton, Ma., 02303-0742
(508) 873-4641
e-mail: JustDivas@hotmail.com
ORDERED BY: SHIP TO: (if different)
Name: Name:
Address: Address:
   
City: City:
State:                         Zip: State:                         Zip:
Phone:    (     )            –       Phone:    (     )            –      
Item # Qty - - - - - - Description - - - - - - Size
S,M,L,XL		 Color
Choice		 2nd
Choice		 Unit
 Price 		 TOTAL
        
        
        
        
        
        

Shipping Information
Divas'Place will do it's best to get the products into your hands as fast as possible.   Once the funds from your check or money order become available, in the U.S.A., shipping will take approximately 5 business days (depending on what part
of the country you live in).

Please feel free to call (508)873-4641 or E-mail with any questions.

*Attach any aditional piece of paper if necessary.*

Total               
Shipping/Handling
U.S. Address
add 5%		              
Outside U.S.A.
E-mail for
shipping cost		              
Massachusetts
Residents add
5% Sales Tax		              
Total Order              
Payment Method:        Check        Money Order


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