LADYLYNNETTE.COM

E-MAIL ORDER TO: LADYLYNNETTE@YAHOO.COM
or call me : 1-765-396-2237 WITH YOUR ORDER.

Name  

Address  

City  

E-MAIL ADDRESS  (required)
  State

Zip Code  

Phone Number  

Fax Number

INSTRUCTIONS:Fill in the ITEM NUMBER and DESCRIPTION for each item being ordered. Indicate the Quantity desired (be sure to remember friends!). Enter the PRICE per item. Multiply the Price per Item times the Quantity ordered of each item. Total each horizontal line (each Item's PRICE, times the QUANTITY ordered). Repeat for each item ordered. ADD UP ALL Prices in the Total column to determine the U.S. Dollar Total for your order. Please add sales tax (NV residents only). Please fill out all information regarding NAME, ADDRESS and E-MAIL ADDRESS. You may pay by PERSONAL CHECK, MONEY ORDER, or US CASH (send cash via registered mail only). WE WELCOME YOUR VISA OR MASTERCARD! SIGN where indicated. Please allow 2-4 weeks for delivery. All prices are in U.S. Dollars.

ITEM/DESCRIPTION/TITLE

QUANTITY

PRICE

QTY x PRICE (TOTAL)

       
   
   
       
   
   
       
   
   
       
   
   
       
   
   
       
   
   
       
   
   
       
   
   
       
   
   
       
   
   
       
   
   
       
   
   
SubTotal
        
Shipping
        

       
Total Due
        
       
       

PAYMENT METHOD:CASHIERS CHECK __POSTAL MONEY ORDER __ CASH

CREDIT CARD: VISA MASTERCARD ACCOUNT NUMBER

EXPIRATION DATE

By submitting this order form I am affirming, that to the best of my knowledge, any and all items which I am ordering via this order form are legal to purchase, own, and possess in my country, state, and / or community. I generally and specifically hereby release and absolve LYNNETTE CARROL from any and all liability arising from any product's unsafe or improper use by me or anyone else whom I may direct in anyway whatsoever. I affirm that I am a private citizen and acting in no capacity whatsoever other than as a private citizen in requesting that nannylynnette.com / abdlworld.com/ Lynnette Carrolo to me. I promise that all the forgoing statements are true and correct and I affirm that I expect LYNNETTE CARROL to rely one the truthfulness of each and ever attestation within this form before shipping medical products to me. (We cannot ship without signature). THANK YOU FROM ALL AT LADY LYNNETTE'S STORE. WE APPRECIATE YOUR BUSINESS!

X__________________________________________Date_________________________

Click the print button on your browser menu after filling out this form. CALL IN THE COMPLETED ORDER FORM TO 1-765-396-2237 or Mail the completed from to: Snail mail orders to: LYNNETTE CARROL P.O. Box 147 HARTFORD CITY, INDIANA 47348. Your products will be on their way to you within days !!!