Georgia's Fur Salon, Inc., Cherry Hill, NJ, U.S.A. -- Fax Order Form

Georgia's Furs FAX Order Form

To order, please print this form, clearly fill out the information below and fax it to us at:
(856) 354-2184

Name:__________________________________________

E-mail:__________________________________________

Street Address:___________________________________

Address2:________________________________________

City:____________________ State:_____ Zip:__________

Phone #:_________________________________________

Size:___________ Height:__________Weight:___________

Credit Card Type:_____________________________________

Credit Card Number:___________________________________

Expiration Date:_______________________________________