Holy Originals ORDER FORM

Please print out this page, complete it, and send by one of the following:

MAIL: Holy Originals, P.O. Box 20398, Sedona, AZ 86341 USA
TELEPHONE: (928) 284-2874; OK to leave message on answering service with your credit card information.
***For Security Reasons, Do Not Send Credit Card info By E-Mail***

Your Name: ____________________________________________________________

Address: ______________________________________________________________

City: _____________________ State/Prov.:______ ZIP/Postal Code __________ Country ______________

Ship this order to me	*IMPORTANT: In case of questions, how do I contact you?* Telephone:______________________________ E-Mail Address___________________________
Ship this order to the person below
Recipient's Name: _______________________________________________________
Address: ______________________________________________________________
Address: ______________________________________________________________
City: _____________________ State/Prov.:___________ ZIP/Postal Code ___________ Country _____________
This gift is from: _________________________________

Payment Method (circle one): Check MoneyOrder

Card Number: ______________________________________________ CVV code _________ (3 digits on back of card)

Exp. Date: _________ Cardholder Name:_______________________________________

Merchandise Order:
Product	Description	Qty.	Price	Total $
_______	_______________________________________	____	_______	__________
_______	_______________________________________	____	_______	__________
_______	_______________________________________	____	_______	__________
_______	_______________________________________	____	_______	__________
_______	_______________________________________	____	_______	__________
_______	_______________________________________	____	_______	__________
_______	_______________________________________	____	_______	__________
		GOODS TOTAL:		__________
		Add: Shipping		__________
Free shipping in the US		FINAL TOTAL		__________