Pet Jewelery Store - Order Form

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PET JEWELERY STORE ORDER FORM
Order Date
Store Name *
Contact Person Name *
Cellphone # *
Address *
City/State/Zip *
Store Phone # *
Email id *

ALL CONTRACT ARE FOR 1 YEAR & RENEWABLE ON 1 YEAR BASIS
APP PACKAGE
Package
Price
Order
One Time Setup Fee
$100.00
Monthly Charges
$20.00

PAYMENT DETAILS
Method Of Payment (select one) *
Account # *
Expiry Date *
CVV Code *
Name as it appears on the card *
Address where card is registered *
Word Verification*
Note:
  • Free 2nd day Shipping
  • $75 Cancellation fee if CAD is done and order not processed in 30 days*
  • If same CAD if processed after 30 days then $75 will be refunded in the order