Talavera Shop
Fax Order
Form
Thank you for your order. PLEASE PRINT THIS PAGE OUT
and fill in your information.
Sign the signature blank, AND FAX TO: 1
(281) 362 8557
If you have any questions about your order, or wish to check
its status, please email us at: may@talaverashop.com
Customer Credit Card Information
| Name on Card: |
| Card Type: (We accept VISA, Mastercard, AMEX, Discover) |
| Card Number: |
| Expiration Date (mm/yy) |
| CVV2 Code: In signature strip on back of card, to the right of the card number, is the 3 digit CVV2. Enter 000 if missing/illegible. |
| Your Address: |
| Your e-mail: |
| Your Phone: |
|
Signature:___________________________________
(Required) |
| Fill in shipping information if different from above. |
| Name: |
| Address: |
| Address: |
Order Summary
Click on the buy button of the pot (s) you are
purchasing. When finished click "View Cart" to fill the information
required bellow.
| Item Ordered: | $ | |
| Item Ordered: | $ | |
| Item Ordered: | $ | |
| Item Ordered: | $ | |
| Item Ordered: | $ | |
| If in Texas add Sales Tax | $ | |
| Shipping Cost: | $ | |
| GRAND TOTAL | $ |
Special Instructions
End of Order