Kristen Uniforms & Linens ~ Order Form
Kristen Uniforms & Linens
2010 Eggert Road
Amherst, NY 14226
Phone # 1-800-432-7571
Fax # 1-716-836-6463
Bill / Ship To Information
Name:
Address:
City, State, and Zip:
Phone #:
Fax #:
E-Mail Address:
Item #	Decription of Item	Qty	Color	Size	Item Price	Total Price
US Ground Shipping and Handling Rates					Subtotal
Please call for International, Next Day or 3 Day Shipping Rates					Shipping
	$0.00 -   $14.99 =   $7.95				NYS Tax
	$15.00 -   $25.99 =   $9.95				Total
	$26.00 -   $49.99 = $11.95
	$50.00 -   $74.99 = $13.95
	$75.00 -   $99.99 = $15.95
	$100.00 - $199.99 = $27.95
	$200.00 - $499.99 = $32.95
	$500.00 - $999.99 = $75.95
	Orders over $1000.00 we will contact you.
	Payment Method - (sorry no cash or CODs) US Funds Only
	_ Visa  _AMEX  _MC  _Check  _M.O.
Print Name:
Card Number:
Exp. Date:
Security Code:
Signature:                                                                                                Date:
	Thank you for your order and have a great day!