PRINT Order Form @ LITURGIX

e-Selection @ iPrices: Orthodox Christian vestments & Liturgical and Church Supplies
L I T U R G I X . C O M

________________________________________________________________________

MAIL ORDER FORM
Use the print button on your browser to print this order form and make your selections.

1. Customer Billing Information (As it appears on your Credit Card)

Email Address:

_______________________________________________

Organization
(Church or Group):

_______________________________________________

Name:

Rev. Mr. Mrs. Ms.:___________________________________

Address:

_______________________________________________

Address line 2:

_______________________________________________

City: ___________________________ State or Province:________________________

Zip or Postal Code:__________________ Country: ______________________________

Phone: _____________________________ Fax: _____________________________

2. Shipping/ Mailing Address

Use the same billing address as the shipping address: _____ (Yes / No)

Name:

Rev. Mr. Mrs. Ms.:___________________________________

Address:

_______________________________________________

Address line 2:

_______________________________________________

City: ___________________________ State or Province:________________________

Zip or Postal Code:__________________ Country: ______________________________

Phone: _____________________________ Fax: _____________________________

3. Your Order Details: Date _________________

Item Code	Item Name/ Fabric Code	Price /pcs	S&H /pcs	Qty	Total
_______	______________________________________	_______	_____	___	________
_______	______________________________________	_______	_____	___	________
_______	______________________________________	_______	_____	___	________
_______	______________________________________	_______	_____	___	________
_______	______________________________________	_______	_____	___	________
_______	______________________________________	_______	_____	___	________
_______	______________________________________	_______	_____	___	________
_______	______________________________________	_______	_____	___	________
_______	______________________________________	_______	_____	___	________
_______	______________________________________	_______	_____	___	________
		SubTotal			________
(Discount coupon code: _______ : ___% OFF / $___ OFF)		Discount			________
(Add S/ H costs for all products)		Total S/H			________
	(Total Price = SubTotal + Total S/H - Discount)	Total			________

Specify the Shipping Method: Regular / Express

4. Payment Method

Payment enclosed:

_____ (Yes / No)

Check or Money Order:

_____ (Yes / No)

Master Card:

_____ (Yes / No)

Visa:

_____ (Yes / No)

Discover:

_____ (Yes / No)

American Express:

_____ (Yes / No)

For Credit Card Orders Only. Please fill out the following:

Credit Card Account Number

_______________________________________________

Expiration Date:

___ ___ /___ ___

Signature:

____________________________ Date: _________________

Do not forget that you can always place your order over the phone, using your credit card.

5. Customer Message or Comments:
(Please specify all your additional requirements, if there are any, regarding your order such as item specifications, shipping, deadlines, etc. Use one line for each item and start with item code. If faxing/ mailing this form you may need to put your comments on a seperate page)

________________________________________________________________________

Ordering Instructions:
(click to read or print your instructions)

Ecclesiastical Vestments
Sticharions
Epitrachelions
Under- and Outer- Cassocks
Chalice Veils
Sacred Vessels
Blessing and Pectoral Crosses
Vigil Lamps
Censers
Miscellaneous Church Supplies

Let us know about your order details and payment method. You are welcome to submit your order in one of the following ways:
* By Email: You may submit your order and measurements online, the fastest method of order processing. Write down email message with the information about your order (use the fields in this form) and send it via email directly to liturgix@liturgix.com. An order confirmation will be emailed back with products' update and your order's ship date.
* By Fax: You may fax your order Toll-free @ 1-866-U-2-FAX-US.
* By Phone: You may call your order Toll-free @ 1-866-Liturgix or (847) 881-1084. Our representatives will be happy to take your phone order or answer your questions. We will be happy to assist you further in finalizing your payment. If we are away, we'll return your call and talk to you regarding any other questions you may have.
* By U.S. Mail: You may send in your order and LITURGIX' measurement chart to our mailing address:

Liturgix.com
P. O. Box #181862
Coronado, CA 92178
USA

When placing the order, please specify the shipping method -- regular or express delivery. Also, please submit the billing address and phone number of the credit-card holder, in case that information is requested by the issuing bank when your payment is processed. ________________________________________________________________________
please feel free to contact us with additional questions or should you have difficulty completing your order:
send mail to: P. O. Box #181862, Coronado, CA 92178, USA or email us at liturgix@liturgix.com
fax us Toll-Free at 1-866-U-2-Fax-US or 1-866-823-2987, & call us at (847) 881-1084, or toll-free at 1-866-Liturgix

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