Name ___________________________________________________________

 

Address _________________________________________________________

 

_________________________________________________________________

 

Telephone #______________________________________________________

 

E-mail address_ ___________________________________________________

 

Would you like to be informed of new items by e-mail? _________________ Reason for return _________________________________________________________________

Modest Apparel USA-ORDER FORM

Pay by: (circle one)

             check

             credit card

             cash

             money order

 

Original invoice #

 

______________

Send to:

Modest Apparel USA

122 Airport rd

Buffalo MO, 65622

www.modestapparelusa.com

info@modestapparelusa.com

Toll free 1-866-269-0907 or 1-417-345-8421

 

SHIPPING CHARGES-Send USPS reg  mail 3-7 days Large orders sent UPS