Twilight BookZone & Other Item Order Form
309 Cedar #1C
Santa Cruz, California 95060
Phone 408-429-6257(hrs:8am -5pm Pacific Standard Time)
Fax/Data 408-471-0230 (hrs:12pm-5pm Pacific Standard Time)
Name: ___________________________________
Address: ________________________________
City: ___________________________________
State: __________________________________
Postal Code: ____________________________
Daytime Phone: (____) ___________________
Send Our Catalog to a Friend
Name: ___________________________________
Address: ________________________________
City: ___________________________________
State: __________________________________
Postal Code: ____________________________
QTY ORDER # TILE OR DESCRIPTION PRICE TOTAL
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Subtotal_________________
CA Residents
Add 7 1/4 %
Tax _______________
Postage _______________
Order Total _____________
Ass/Disc _______________
Grand Total _____________
Method of Payment:
____ Check or Money Order
____ Charge it to my: ____ Visa ____ MasterCard
Credit Card Number: ____________________________
(Please include all digits)
Expiration Date: ____/____
Print Name Exactly as on Card _________________________________
Sign Name Exactly as on Card _________________________________
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Shipping Instructions: (Please Choose One) * *
* *
____ Ship Postal-Surface Rate * *
____ Ship Priority-AirMail (Priority in USA) * *
____ Ship UPS (Mainland USA only - No PO boxes) * OFFICE USE ONLY *
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