ADDRESS:
LA GARMENTS
23411 ALISO VIEJO PKWY, K165
ALISO VIEJO, CA 92656
FAX THIS FORM TO:
(949) 315-3171
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UNITED STATES Shipping charges based on current UPS rates
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| INTERNATIONAL shipping charges based on current FEDEX rates |
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Total
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For more items, please print and include a second form.
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Customer Information:
* First Name ________________________
* Last Name ________________________
Company ________________________
* Email ________________________
Phone ________________________
Credit Card Information:
*Card Type ________________________
*Cardholder’s Name As Shown On Card ___________________________________
*Card Number ______________________
*Expiration Date (mmyy) ____ / ____
*3 Digit Security Code _______________
*Required fields.
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Billing Address:
*Address Line 1 ______________________
*City _______________________________
*State/Province _______________________
*Country _____________________________
*Zip/Postal Code ______________________
Shipping Address:
(if different from billing address)
Ship To Name __________________________
Address Line 1 __________________________
City __________________________________
State/Province __________________________
Country _______________________________
Zip/Postal Code _________________________
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Thank you for ordering from LAGARMENTS.COM
If you have any questions, please do not hesitate to contact us at: (949) 297-4422, or by email at: INFO@LAGARMENTS.COM
