For the fast and accurate service, please complete all of the following section. After you summit this form you will be getting a phone call from our sales representative and will confirm your order. Following information you summit here will be neither disclosed nor used for any other commercial or personal purpose. Thank you.

Billing

Name

Address

Telephone Number(must)
Company Name

City, State, Zipcode

Fax Number ( if any)


Shipping    Same as billing

Name

Address

Telephone Number(must)
Company Name

City, State, Zipcode

Fax Number ( if any)


Order Detail  
E-mail address
Payment Method
Credit Card   Check  Cash

If you have any question about payment method, contact us at 1-888-481-7741.


If you are repeating order, please input followings;
Last Invoice #
Invoice Date(mm/dd/yy)
 
    Item Number                Quantity           Shipping Date              Remark

If you don't have any e-mail application like Outlook Express, you can't use this form to place your order. Please, print out this form and fax us.



Copyright 2003, Uomo Venetto Inc. all rights reserved. Any Questions to uomo@venetto.com
<