Form

2840 Q Street
North Highlands CA 95660
Phone 1 800 515 1977                       Fax 916- 983 6649
Website www.italartworld.com
Email sales@italartworld.com
 

Order Information
Item name

Art#

Quantity

Price

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Total

Billing Information
Please list your billing address. This is also the address to which products will be shipped unless otherwise specified below.

Name _______________________________________ Phone (______)_______-________

Address ___________________________________________________________________

City ____________________________ State _____________ Zip _________________  

Credit Card (Circle one): Visa / MasterCard / American Express

Card# _________ _________ _________ _________ Expiration MM/YY) ___/___

Signature _______________________________ Date Signed _____/_____/_____

Shipping Information
Only complete this area if you would like the products shipped to an address other than the one listed above (i.e. a gift).

Name ______________________________________ Phone (______)_______-_________

Address ___________________________________________________________________

City _____________________________ State _____________ Zip ________________

Special Instructions
Note any special instructions below:

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