Print out this page, fill in your Credit Card information including Number, Expiration Date, Name, Billing Address then fill in the Shipping Address, Phone Number, Items being ordered and Sales Tax (CA residents).

FAX to 626-915-0883

 Today's Date:

Credit Card Number:

Expiration Date (Month and Year):

NAME and BILLING ADDRESS As Appears On Your Credit Card

Name:
Address:
City: State: Zip:

SHIPPING ADDRESS (Must be a street address; we cannot ship to P. O. boxes.)
Name:
Address:
City: State: Zip:
Daytime Phone in case we have a question about your order
(Include Area Code):

Quantity

Description and Model Number

Price Each

Total Price

       
       
       
       
       
       
       
 
 
 
 
Merchandise Subtotal
Shipping & Handling (See Chart)
Sales Tax (CA residents)
TOTAL

SHIPPING & HANDLING CHART

Subtotal up to $25.00 . . . . Add $8.95
$25.01 to $45.00 . . . . . . . Add $10.95
$45.01 to $65.00 . . . . . . . Add $12.95
$65.01 to $85.00 . . . . . . . Add $14.95
$85.01 to $99.00 . . . . . . . Add $16.95
$99.01 and up . . . . . . FREE SHIPPING

These shipping rates apply ONLY to the Continental United States

Call for information on Express Shipping
Allow three to four weeks for delivery

Lamps Beautiful
527 N Azusa Ave #399
Covina, CA 91722
Phone: 866-339-5060

Thank you for your order!