Please fill out the form below on your computer and then print it out using the print button on your browser.

Make checks payable and mail this form with the appropriate fees to:

Pam Lauritzen & Co.
2702 Covington Dr.
Garland, TX 75040

If you are paying with a credit card, you may fax this form to 972-530-3313 for faster processing.

Product Order Form

First Name

   Middle Initial    Last Name

Billing Address

Address (cont'd)

City

State/Province Postal Code

Country

Ship To

Same as Billing Address

Street Address

Address (cont'd)

City

State/Province Postal Code

Country
 
  

Home Phone

           Fax

Business Phone

E-Mail

Web Page

Product 

I affirm that statements supplied by me on this form are true and correct. I also acknowledge that I have read and understood the PetStylist.com Return Policy.

Signature ________________________________          Date ____________

Payment Method

check     money order     Discover
VISA      MasterCard      American Express

Card Number      Expires

Security Code (located on back of card)

 

Signature ________________________________