Product Order Form

Please fillout the form below and click on SEND ORDER to submit your order. Note that bold titles indicate required fields which must be filled before submitting the form. You can also print out this form, fill in the blank fields and send it via fax to Beauty Charm Company at (973)285-9391.

Product Information (bold fields are required) Product Number  Product Name / Size / Color Quantity Unit Price                                                                       Select Shipping Method: Select Shipping Method Ground Shipping $8.50 Overnight Shipping $24.00   Comments:

   

Billing Information First Name:    Last Name: Street Address:   City: State-County:    Zip/Postal Code: Country: E-mail Address: Phone Number: Fax Number:         Payment Method: Select Credit Card Visa Master Card Discover American Express Credit Card Number: Expiration Date: (mm/yy) Name on Card:

   

Shipping Information (only if different from the billing address) First Name:    Last Name: Street Address:   City: State-County:    Zip/Postal Code: Country: Phone Number: Fax Number:

Print this page for your record before pressing SEND.

If you have any problems using this form, please send us email.