PavoniShop.com Printable Order Form

PavoniShop.com La Pavoni Online Store
89 Long Branch Ave - Long Branch, NJ 07740 FAX 801-730-3937
Print this form and mail or FAX it to us.

Please do not order items that are not listed as "In Stock" on our web site or delivery may take 4-6 weeks or more. In stock items normally ship within 2 business days. We do not sell parts or items that are not listed on our web site. We do not accept payment by check or money order.

(A) Ship To: (name and address)	(B) Bill To: (if different from Ship To)
Name: _________________________	Name: _____________________
Address: _______________________	E-mail: _____________________
Address:_______________________	Address: ___________________
City:_________ State:___ Zip:______	Address: ___________________
Telephone:_____________________	City:________ State:___ Zip:____
	Daytime Telephone:____________

Item #:	Item Name:	Quantity:	Price per Item:	Total:
_______	_________________________	______	___________	_________
_______	__________________________	______	___________	_________
_______	_________________________	______	___________	_________

(D) Totals & Shipping:

purchase amount:	shipping:
up to $60.00	Free	Merchandise Total:________
$60.01-$110.00	Free
$110.01-$220.00	Free	UPS GROUND Shipping (see chart):________
$220.01-$440.00	Free	UPS can not ship to Post Office Boxes
$440.01-$660.00	Free	We are sorry, we can not ship outside the US.
$660.01-$880.00	Free	Alaska & Hawaii please call for UPS 2nd Day Air Rates
$880.01-$1100.00	Free
over $1100.01	Free	TOTAL:_______

(E) Method of Payment:
___ American Express ___ Mastercard ___ Visa

Credit card #____________________________ & exp. date:____________
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FAX Order Line 801-730-3937