SIGNATURE___________________________________________________
QTY. 
ITEM  NO.   
         DESCRIPTION          
SIZE(mm)
    COLOR   
  PRICE (ea)     
#          
#          
#          
#          
#          
#          
#          
#          
#          
#          
#          
#          
#          
#          
#          
#          
#          
#          
SHIP VIA
 GROUND
 $4.50-8.50
   NEXT DAY
   $32.95
 2ND  DAY
   $18.95
        3 DAY
        $14.95
 
CIRCLE ONE  $175.00 free      TOTAL  
I HAVE READ THE TERMS OF SERVICE BEFORE ORDERING
To place your Beadcorp wholesale order by fax, print out this form and fax to: 813-662-1419
We do not ship to p.o. boxes minimum order $35.00
Florida Customers please fax us your 2007 FL. Sales Tax Cert. before placing order
Name:__________________________________________________________
Address:_________________________________________________________________
City:_________________________State:_________Zip:____________________
Phone:__(_____)__________________E-mail:____________________@______________
  1. C.: (Visa)___ (MC)____ C.C. # ________-________-________-________

select one (Amex)_____ (Disc)____EXP.____________CCv2# on back __________
(what's this)