Shipping
information (All US orders shipped by UPS for $10 for 1-5 items
and $20 for 7-12 items) |
| Ship to:____________________________________________________________________________________ |
| Address:___________________________________________________________________________________ |
| City/State:_______________________________________________________Zip:________________________ |
| Country:___________ Telephone:____________________________Email Address: ________________________ |
| Billing information Check here if same as shipping address: |
| Name:_____________________________________________________________________________________ |
| Address:___________________________________________________________________________________ |
| City/State:_______________________________________________________Zip:________________________ |
| Country:___________ Telephone:____________________________ Email Address:________________________ |
| Method of Payment: ____Check or Money Order: Amount (US dollars): $__________ or _____Credit Card |
| Credit Card#:____________-____________-____________-____________ Expiration Date:_______/_________ |
| __________________________________________ ______________________________________________ |
Cardholder's
Name (Please print) Signature
(Required) |
| Order Total (including shipping as quoted above): $_______________________ |
| ITEM |
SIZE/COLOR |
PRICE |
QTY |
TOTAL |
Gemini
Boutique 1315 Celebrity Circle Myrtle Beach SC 29577 |
 Phone:(843)916-0067 Fax:(843)916-0336 |
Order
by Phone or Fax
Simply print out the blank form below,
then browse our products and use the blank form to fill in the items you would like to order. Then call or fax us! |