Fax Order Form
                                                                                                                   [787] 795-1246

Your Contact Information:  Recipients Information:
First Name:
Last Name:
Email Address:
Phone Number:
Mobile Number:
Fax Number
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Occasion:
Delivery Date:
 

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Special instructions for delivery [if any]please be specific!

 
First Name:
Last Name:
Email Address:
Phone Number:
Mobile Number:
Office  Phone Number:
Address Street:
Apt#  House#
City:
Urbanization/Barrio
   
Name of the Item
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Item Price:
 
Select  delivery charge:


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Total amount to be charged:
Print page this page and send by fax to 787-795-1246

We will contact you with the total for the order including the 7% Tax and for  your payment information.