Print and send with your payment. We accept Checks, Money Orders, and Credit Cards
Willowroot ~ Real Magic Wands
Order Form
Name: _________________________________________________________________
Address: _______________________________________________________________
City: _____________________________ State: ___________ ZIP: _______________
Country: _______________________
E-mail: __________________________________ Phone: ________________________
Payment: Check ___ Money Order: ___ International Money Order: ___ Credit Card ____
___________________________________________________________________________
Credit Card # __________________________________________ Expiration Date: ___________
Name on CC: ____________________________ Billing Address:
___________________________________________________________________________
Item: ______________________________________________________________ Price: ______________
Item: ______________________________________________________________ Price: ______________
Item: ______________________________________________________________ Price: ______________
Item: ______________________________________________________________ Price: ______________
International Customers send $13.oo for Shipping Shipping: $7.oo
Canadian Customers pay US Shipping Rate ____________________
TOTAL: $
___________________________________________________________________________________
Notes:
____________________________________________________________________________
Mail to:
Willowroot Real Magic Wands
PO Box 576 :
Benicia, CA 94510 :