ScandiStyle™ Order Form
Use your credit card to order by phone +515.229.1991 or 515.963.0161 (9-5 CT).
Or fax +515.965.0267 anytime.

Or mail to:
ScandiStyle™ Design — 317 NW Crestview DR — Ankeny, Iowa 50023   USA
Ordered by (print Name, Street (plus apartment or other number), City, State/Province, Zip/Postal Code, Country)
  
Day phone: area code, number, extension

_______-__________-______________

Fax number: _______-__________-______________

Email address:

___________________@_________________________
Delivery Address: (use for delivery destination if different from above)
 
Payment method: check/money order: $________

__Visa __MasterCard Expires: __Month _____Year

Credit card #: _____-______-______-_______

Signature:

Product Number
Quantity
Description
Color / Style
 Price Each
Total
           
            
           
           
           
     
 Subtotal:
  $
 6% sales tax (plus any local option tax) for Iowa orders only:
   
Shipping/handling (USA lower 48):
  
Rush ($8 additional):
  
   
 Ship to each additional address:
   
   
 Order Total:
  $
Charges for first delivery address (USA lower 48).
Other destinations, please inquire.
Total price of items
Shipping & handling
under $25.00
$5.95
$25.01 - 50.00
 $6.95
$50.01 - 100.00
 $8.95
$100.01 - 150.00
 $10.95
over $150
$12.95
Each additional address add $4.25

Order Date: _______/________/200___
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