Pastease Mail Order Form

by color:

White
Black
Pink
Purple
Red
Blue
Turquoise
Yellow
Green
Orange
Glow
Nude
Sparkle
Prints
Metallic

by style:

Rockstar
Sweety
Daisy
Butterfly
Flames
Sparkle
Leaf
Sunny
Xs
Hands
Girlies
Kisses
Sheshells
Iron Cross
Glow
Nude
Clovers
Minis
Skull*
Cherry*
Snowflake*
Sets
Refills

(Use this form to pay by personal check or money order)

Complete this form, print it and mail or fax it, along with your check or money order to:

PCI Fashion
2235 E Flamingo Rd Ste 201G
Las Vegas, NV 89119
FAX: 775 845 8620

Billing Address Shipping Address (if different)

Name: Name:

Address:

Address:

City:

City:

State:

State:

ZIP Code:

ZIP Code:

Email:

Phone:

Item#	Description	Quantity	Unit Price	Amount





			Subtotal:

US$3.00 S&H Continental US for orders less than US$44.00 US$6.00 S&H Continental US for orders more than US$44.00		Shipping:

7.25% sales tax for California State residents only)		Sales Tax:

Total:

If you need help placing your order, please contact us at: pastease@pastease.com

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