Mail Order Form
Bill To: Ship To: (if different)
Company: Company:
Name: Name:
Address: Address:
City: City:
State & Zip Code: State
Phone: Zip Code:
Email: Phone:
Item Number Color Size Description Qty Price ea. Total
             
             
             
             
             
             
             
             
             
             
             

UPS Ground Shipping Charges
Orders $0.00 - $58.99 = $8.50
Orders $59.00 and up = FREE SHIPPING

 Subtract Gift Voucher Amount:    -
Sub Total:  

Indiana Residents add 6.00% Sales Tax:

  
Shipping:  
Voice 877-652-9675 / FAX 269-697-4514 / www.workingperson.com.com
 Total:  


METHOD OF PAYMENT

Check or money order payable to: The Working Person's Store

If ordering by Credit Card, please fill in the information below:

VISA Master Card Discover American Express


MAIL TO:
The Working Person's Store
15198 N. Main St.
Buchanan, MI 49107

FAX TO:
269-697-4514


CREDIT CARD NUMBER
EXPIRATION DATE
AMOUNT


CVV2 CODE
NAME AS IT APPEARS ON CARD

 
SIGNATURE DATE