________________ ___________________ __________
Last Name First Name MI
________________________________________________
Address
________________________________________________
Zip Code ___________
Phone (_______)______________
Please charge my (circle
one)
□ MasterCard □ Visa □ Discover □ American
Express
Card#____________________________
Exp(mm/yy)____
Security Code____ (last
three digits on the back of the card)
Cardholder signature___________________
Date_______
If paying by check,
please make it payable to: Simpro Inc.
(Please include driver’s
license number on the check)
NatureSpiritâ Chandelier/Lighting
1001/12+8+4[
] _____ x $1349 = $_________
1002[ ] _____ x $1449 = $_________
1003[
] _____
x $1149 = $_________
1005[ ] _____
x $299 =
$_________
101[ ] free shipping___ x
$59 = $_________
TX
residents add 8.25% sale’s tax $_________
Shipping/Hanling/Insurance
add $50 each
$_________
Total
Amount Due $_________
Please mail your order
to:
Simpro Inc. 2018
Primrose Dr, Irving, TX 75063
Order by fax:
1-800-383-2082
www.naturespiritproduct.com
PromCode: