.Printable Order Form for
Lola Merchandise

Just print this form on your printer by clicking on the "print" button in your browser, fill it out manually and mail to the address below or fax to: 949-499-9870. Orders are usually processed within two weeks. Our forms are designed to help protect the privacy of your credit card number.

 
Quantity
Item #
Description
Price Each
Total Amount
         
         
         
         
         
         
         
         
(tax is included in the item price) Shipping & Handling:
FREE
TOTAL:  
 


.......Enclosed is my check in the amount of $ _______________ ..
----- OR ..Please charge my credit card:

.......(circle one)... VISA.... MASTERCARD....
  .......Card # __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __........Exp. Date __________
 
.......Signature: _________________________________________________________

.......Name as it appears on card: ___________________________________________

.......Street Address: _______________________________________Apt. #__________

.......City: ____________________________________State_______Zip_____________

.......Phone:__________________________________ Email:_____________________
 
MAIL FORM TO:..


LOLA MERCHANDISE
P. O. Box 9348
South Laguna Beach, CA 92652


..............Thank you for your order!