SHALLYN Online Order Form

 

SHALLYN
# Fields must be filled up for submission  / Terms and Policy

Please send your check or money order for the below price. Your order will be sent once the monies have been received. Thank you for your order!  Print order form and send a copy to SHALLYN, 114 DeKalb Street, Bridgeport, PA 19405, Operations Department and keep a copy for your records.

Please provide the following ordering information: Checks payable to: SHALLYN       

See Shipping and Handling  Note: Monthly specials are automatically given with order form purchases, if applicable.

 

First Name #                                                       Date: mm/dd/yy
Last Name #                                             
Email Address (Necessary for confirmation)             
Address Line 1 #
Address Line 2
City #
State # Zip #

Daytime Phone # (Necessary for confirmation)

For shipping information, if different than above

 Address Line1 #
 Address Line2
City #
State # Zip #                                                                                                                    

 Check Money Order       (Monthly specials will be deducted in-office)

If you are purchasing single ticket place the number amount of tickets in box. For Group Rates, place the number 1.

Order Form Via Mail Submission
Item Name	Qty	@Price	SubTotal
		@
		@
		@
Sales Tax:	Orders exceeding quantity 60 please contact SHALLYN sales office	Non-applicable
Shipping&Handling:	.44 postage		$
TOTAL: