DANCE FLATS ORDER FORM

FLATS, NO SEQUIN TRIM:

I would like to order 1 pair of gold flats, without sequin trim, for $4.95 in size:

        5        6        7        8

I would like to order 1 pair of silver flats, without sequin trim, for $4.95 in size:

        5        6        7        8        9        10

I would like to order more than 1 pair of flats for $4.95 each, as described below:

FLATS, WITH SEQUIN TRIM:

I would like to order 1 pair of gold flats, with sequin trim, for $9.95 in size and trim color:

        5        6        7        8

        Red    Pink    Blue    Gold    Silver    Peacock    Fuchsia    Turquoise

I would like to order 1 pair of silver flats, with sequin trim, for $9.95 in size and trim color:

        5        6        7        8        9        10

        Red    Pink    Blue    Gold    Silver    Peacock    Fuchsia    Turquoise

I would like to order more than 1 pair of sequined flats for $9.95 each, as described below:

SHIPPING:

I live in the United States and want Air Mail shipping (3-4 days) for 1 pair for $4.

I live in the United States and want Air Mail shipping (3-4 days) for 2-4 pairs for $6.

I do not live in the United States, please calculate the shipping charge.

OTHER ACCESSORIES:

I do not want any additional accessories, my Order is complete.

I would also like the following accessories:

PAYMENT INFORMATION:

Name:              Telephone:

E-mail:             Repeat E-mail:

I will pay with a Visa or Master Card, the credit card information is below.

I will send a Check or Money Order.

I will pay with PayPal.

CREDIT CARD INFORMATION:

Name on Card:

Card Number:

Expiration Date:

Last 3-digits on Back:

CREDIT CARD BILLING ADDRESS:  (We ship to billing addresses only.)

Street/Number:

City/State/Country:

Zip/Postal Code:

I have the following questions/comments/requests:

Thank you for your order!  We will send you a confirmation e-mail soon.  Please refer to our FAQ page for our "Terms of Sale".