FaxMailOrderForm

For customers wishing to Fax or Mail in an order, please print this
form out and fax (or mail) to the number (or address) below.

Our policies can be found on the About Me page, click here.

Today's Date:

Shipping Date Request:

Ship To:

Name:

Address:

City

State

Zip/Postal
Code:

Country:

Telephone:

Bill To:

Name:

Address:

City

State

Zip/Postal
Code:

Country:

Telephone:

Email:

UPS/FedEx Shipping is free on all orders over $150 within the Continental United States Only

Shipping:

Gift Wrapping:

Sub Total:

AZ Sales Tax 8.10%
(For orders shipped to
AZ address only)

Special Instructions:

Total Price:

Thank You for your Order.

Orders via Personal Check will require an
additional 7 day check clearing period.

A confirmation via email or phone will be
made within 48 hours of receipt of your order.

email: orders@yinyanghome.com

Please Fax your order to 1-206-202-0307

or

Mail this form with your Check, Money
Order or Cashier's Check to:

Yin Yang Home
4747 E. Elliot Rd #29-603
Phoenix AZ 85044

Optional > press the
Submit button upon
completion of this form
to alert us of your order.

Please charge this order to a credit card.

Card Type:

Card #

Expiration Date:

Name on Card:

Signature: