1.) Please type in the information below. (Handwriting can be difficult to read.)
2.) Credit Cards orders must be delivered to your same address that is on your credit card statement.
3.) Print out the order form after you have typed in the fields.
4.) If it is a credit card purchase don't forget to sign it in the cardholders signature, then Send to us.

 

  

 
Printable Order Form
All funds must be drawn in US Dollars.  Money order are to be made out to ePed, Inc
No INTERNATIONAL ORDERS.

QTY

ITEM #

COLOR

SIZE

COST EACH

TOTAL COST

SUB-TOTAL

ADD SHIPPING FROM Shipping Page 

TOTAL $ 

PAYMENT METHOD: 
CARD NUMBER: 
EXPIRATION DATE (MM/YY)
Credit Card Verification Code number on credit card click here for explanation: 
CARD HOLDER'S NAME:
CARD HOLDER'S SIGNATURE:
 
 
 

SHIP MERCHANDISE TO: (if it is a credit card purchase fill in the billing address of the credit card)

NAME:

ADDRESS:

CITY/TOWN:  
E-MAIL:

STATE/COUNTY:               ZIP/POST CODE:

TEL #

 

Mail To:
Just High Heels
 58 Loughney Bay
Hudson, WI 54016

 

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