Wade Street Originals
On-Line Order Form
108 West Wade Street, Wadesboro N.C. 28170
Customer Service: 704-694-2191
Orders: 800-440-2191
Fax: 704-694-2191
www.WSOgifts.com
Name:_________________________________
Street Address:__________________________
City:____________________ State:_________
Zip:___________ Country:____________
E-Mail_________________________________
Phone:______________ Fax:_______________
Payment Information
You may use your VISA, MASTERCARD, PayPal, money order or personnel check. Please print this form and mail or fax to us with your payment or call us on our toll free order line.
Credit Card: circle one - Mastercard - VISA Card Number:__________________________
Exp. Date:__________ Personnel Check #___________ Money Order #_______________
Todays Date:________
Item # Description Unit Price Quantity Total
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Sub Total ________
Shipping ________
Tax ________
Total ________
North Carolina residents add 7% sales Tax
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