www.
Billing Info: Ship to:
Check if same as Billing
Name:       Your Name:              
Address:                       Address:                           
    Suite/Room/Apt# :            
City:       City:              
State:     Zip: State:         Zip:    
Telephone: (            )     Telephone: (            )            
                   
Style # Color / Print Size Description Qty Price Each   Total Amount
                 
                 
                 
                 
                 
                 
                 
                 
                 
                 
                 
                 
MERCHANDISE TOTAL:    
Payment Options:        
Check
Money Order Shipping From Chart:    
      Bill my existing account
Payroll Deduction
     
Charge:
Visa Mastercard
AMEX
Discover
SUBTOTAL:    
Acct. No:               -                     -               -                    MO. Sales Tax (7.575%):    
Exp. Date: / C V V 2:     (Missouri Residents only)    
Signature:_________________________________   ORDER TOTAL:    
           
48 States Regular Shipping & Handling Charges                    
Merchandise Total Add     Orders paid by check will be held 10 business days to clearce.
Up to $25.00 $7.95        
$25.00-$34.99 $8.95     Group orders are always welcomed. Please call  
$35.00-$74.99 $9.95     our office if you have an order of 50 or more pieces.  
$75.00-$149.99 $10.95        
$150.01-$199.99 $12.95     All returns must occur within 15 days and will be assessed
$200.00 & Above $14.95     a 25% restocking charge unless you require a color or size
exchange. No exchanges or returns on customized, altered,
or embroidered items. Return or exchange items must be
unwashed, unworn, in original packaging with labels and tags
intact. Shipping or handling charges on the original order,
return items, or replacement merchandise are non-refundable.
Returns and exchanges must be authorized in advance
by contacting us at:  
RETURNS@UniformsAndScrubs.com