ENVY ESSENTIALS
BILLING ADDRESS:  (MUST BE SAME ADDRESS AS CREDIT CARD STATEMENT)		SHIPPING ADDRESS: (MUST BE STREET ADDRESS FOR UPS DELIVERY)
NAME:		NAME:
Street Address:		Street Address:
Suite or Appt.#:		Suite or Appt.#:
City/State/Zip:		City/State/Zip:
Email Address:		Email Address:
Daytime Phone #: (     )       -		Daytime Phone #: (     )       -
************PAYMENT OPTIONS************
_____Money Order (MUST BE MAILED IN & RECEIVED AT ENVY OFFICE PRIOR TO ORDER SHIPMENT)
Credit Card#________________________ Exp: __/__ Auth.# ____
************ORDER BREAKDOWN************
ITEM #	DESCRIPTION	QUANTITY	PRICE (EACH)	EXTENDED PRICE
SUB-TOTAL
UPS SHIPPING COST (REFER TO SHIPPING CHART)
ALL TENNESSEE CUSTOMERS ADD TAX @ RATE OF 9.75% =
ORDER TOTAL: =
Thank you,Envy!