Order

Form

Amfora Co 7145 Watt Ave Ste 5
North Highlands CA 95660
Phone 1 800 515 1977 Fax 916- 515 1639
Email sales@italartworld.com

Order Information
Item name

Art# __________

Quantity _________

Price _________

Total _____________________________________


_________ _________ __________ __________
Subtotal (CA residents add sales tax) __________
Freight __________


Total _______________ 

Billing Information
Please list your billing address. This is also the address to which products will be shipped unless otherwise specified below.

Name _______________________________________ Phone (______)_______-________

Address ___________________________________________________________________

City ____________________________ State _____________ Zip _________________

Email _____________________________________________________________________
Credit Card (Circle one): Visa / MasterCard / American Express

Card# _________ _________ _________ _________ Expiration MM/YY) ___/___

Signature _______________________________ Date Signed _____/_____/_____

Shipping Information
Only complete this area if you would like the products shipped to an address other than the one listed above (i.e. a gift).

Name ______________________________________ Phone (______)_______-_________

Address ___________________________________________________________________

City _____________________________ State _____________ Zip ________________

Special Instructions
Note any special instructions below:

___________________________________________________________________________

___________________________________________________________________________

Order

Form

Amfora Co 7145 Watt Ave Ste 5
North Highlands CA 95660
Phone 1 800 515 1977 Fax 916- 515 1639
Email sales@italartworld.com