KohlQuest
ArtSpeak ::
Fax and Mail Order Form
PLEASE PRINT YOUR RESPONSES
DATE ___________
Name of Non-Profit Organization (if applicable] _________________________________________
Non-Profit Organization ID NUMBER [if applicable] ______________________________________
First and Last Names _____________________________________________________________
Street
Address
______________________________________________________
City, State, Zip Code, Country ______________________________________________________
Email Address (for order confirmation)
______________________________________________
Daytime Phone (Area Code first)
_______________________________________________
Shipping Address
[ ] Check here if same as above
Street Address
_________________________________________________________
City, State, Zip Code, Country
____________________________________________________
DIRECTIONS:
1. Print out this order form. If you don't have a
printer, just write all pertinent order information on a plain sheet of
paper and mail or fax it with your payment.
2. Fill in all lines. Be sure all information you
provided is accurate.
3. Be sure to include the correct shipping and handling
information before entering your final order amount.
4. If you are paying by credit card, please be sure you have
submitted the correct card number and expiration date and signed your name
on the CREDIT CARD OWNER AUTHORIZATION SIGNATURE line.
5. If you are mailing in your order, please include a check or
money order made payable to KohlQuest. Mail your completed
order form with payment to:
KohlQuest
3271 Polk County Line Road
Rutherfordton, NC 28139
6. If you are faxing your order form, fax to: (828) 286-9786
