Complete form and mail or fax to:
RoundBrushHair!
8242-D Sandy Ct.
Jessup, MD 20794

FAX: 301-617-3402

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Bill To: Ship To:

Name: Name:

Address: Address:

City: State: Zip: City: State: Zip:

Phone: Phone:

e-mail address (needed for order/shipping confirmation):

Product Size Qty. Product # (if available) Price Each Total Price

Order Subtotal:
Maryland Residents Add 5.00% Sales Tax:

Shipping & Handling (see chart below):

Your Order Total Due:

SHIPPING METHOD: FedEx Ground Home Delivery

U.S.A. Order Subtotal
$0.00 to $24.99 =
$25.00 to $49.99 =
$50.00 to $99.99 =
$100.00 to $124.99 =
$125.00 + =
U.S.A. Shipping Cost
$7.50
$9.50
$11.50
$13.50
$15.00

PAYMENT METHOD. Sorry, no CODs. (Check One)
__Check or Money Order (payable to RoundBrush, LLC) __VISA __MasterCard __American Express __Discover

Print Name on Credit Card:

Credit Card Number: CCID: Expiration Date:

Signature: Today's Date:
Š2007 RoundBrush!, LLC -RoundBrushHair.comŽ

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Bill To:			Ship To:
Name:			Name:
Address:			Address:
City:	State:	Zip:	City:	State:	Zip:
Phone:			Phone:
e-mail address (needed for order/shipping confirmation):

	Product	Size	Qty.	Product # (if available)	Price Each	Total Price





				Order Subtotal:
				Maryland Residents Add 5.00% Sales Tax:
				Shipping & Handling (see chart below):
Your Order Total Due:

SHIPPING METHOD: FedEx Ground Home Delivery
U.S.A. Order Subtotal $0.00 to $24.99 = $25.00 to $49.99 = $50.00 to $99.99 = $100.00 to $124.99 = $125.00 + =	U.S.A. Shipping Cost $7.50 $9.50 $11.50 $13.50 $15.00

PAYMENT METHOD. Sorry, no CODs. (Check One) __Check or Money Order (payable to RoundBrush, LLC) __VISA __MasterCard __American Express __Discover
Print Name on Credit Card:
Credit Card Number: CCID:	Expiration Date:
Signature:	Today's Date: