Varanasi Silk Handicrafts' Order Form





Please fill-in the information below and press "SUBMIT" at bottom of page
Customer Information:

Customer Name: Address: City: ST/Province: Zip (USA): Postal Code: Country: Telephone: Fax: E-mail: E-mail:


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Order Calculator
Enter Quantity desired..then Click on "Calculate Results"
Item
Quantity
Price Each
Amount
Item 01
$3.00 Each $
Item 02
$3.00 Each $
Item 03
$5.00 Each $
Item 04
$5.00 Each $
Item 05
$5.00 Each $
Item 06
$5.00 Each $
Item 07
$5.00 Each $
Item 08
$5.00 Each $
Item 09
$5.00 Each $
Item 10
$5.00 Each $
Item 11
$6.00 Each $
Item 12
$6.00 Each $
Item 13
$10.50 Each $
Item 14
$10.50 Each $
Item 15
$10.50 Each $
Item 16
$10.50 Each $
Item 17
$10.50 Each $
Item 18
$10.50 Each $
Item 19
$10.50 Each $
Item 20
$10.50 Each $
Item 21
$10.50 Each $
Item 22
$10.50 Each $
Item 23
$10.50 Each $
Item 24
$10.50 Each $
Item 25
$10.50 Each $
Item 26
$10.50 Each $
Item 27
$10.50 Each $
Item 28
$10.50 Each $
Item 29
$10.50 Each $
Item 30
$10.50 Each $
Item 31
$10.50 Each $
Item 32
$10.50 Each $
Item 33
$10.50 Each $
Item 34
$10.50 Each $
Item 35
$10.50 Each $
Item 36
$18.00 Each $
Item 37
$18.00 Each $
Item 38
$18.00 Each $
Shipping: $0-$50.00 $5.00;  over $50.00 10% Total
$
SubTotal: $
The above amount is your total including shipping charges.
TAX TOTAL:
Sales Tax - Add 0.00% Tax.
Tax: $ $

Payment by Western Union Money Transfer®

You can phone in your card number: 1-800-CALL-CASH℠

You can make a credit card purchase on line: www.westernunion.com.

In either case, please deliver payment to:
Manish Seth
c/o GLORIUS SERVICES
D-48/131, HEERA MARKET
VARANASI
UTTAR PRADESH 411002
INDIA
Tel: (91) (054) 2420702

Please be sure you have completed and/or re-checked
the information at the beginning of this form for accurancy.


(For your records: please PRINT this order page before clicking SUMBIT.)

Thank You For Your Order!


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