Jais and You
Jais and You

New Collection

Many new Products!


Jais and You

Let us help your skin preserve & renew itself naturally

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Order Form

Jaiís Custom Made Soaps Mail Order Form

Send To: Jaiís Custom Made Soaps, P.O. Box 930145, Norcross, GA30003

Please Print and Fill in Form Completely.

Name:

Co. Name:

Payment Type (Circle One):

 

E-Mail:

Visa, M/C, AMEX, Discover, Personal/Business/Cert. Check, M.O.

Phone #:

Fax #:

Card Expiration Date:

How did you find us?

Customer #

Credit Card #

 

Address:

City, State, Zip:

Business Type:

Ship To:

Company Name:

Contact Name:

Purchase Order#:

Complete Address:

Special Delivery Instructions:

 

 Item

Size

Quantity Each

 

Description

Price Each

Extended

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Subtotal:

(GA. Res. Only Add (5.0 %):

S/H:

Order Total:

 

Authorized Signature (MUST SIGN):


Call in your Orders 770-374-8389


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