Afiber Mannequins

Afiber Inc.

34-36 Summit st East Orange NJ 07017

Fax (212)380-1708

Fax Order Form

Please Fill in all proper information which is found next to each item ( Item Number, Price, Color and Shipping)

Item Number

Color

Price

Shipping
  NY Resident Tax (8.625%)
 
Total

PAYMENT:
 Credit Card  

 
Card Name
Card Number
Expiration Date
                         CVV Code
 
Bill To:
First Name
Last Name
Address
City
State
Post Code
Phone
Email
Country
Ship To:
Same as Billing Address
Ship to Name
Address
City
State
Post Code
Country
Order Comments and Special Requests