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| THE INNER LIGHT SHOPPE MAIL ORDER FORM |
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We only ship to the United States and its Territories plus all Provinces of Canada. Print out then hand fill in or
type in your order information then Mail. Any questions call between 9:00 am & 5:00 pm (248) 852-0126
type in your order information then Mail. Any questions call between 9:00 am & 5:00 pm (248) 852-0126
Today's Date: __________________________
BILL TO:
Name:_____________________________________________________________________________________
Address:__________________________________________________________________________________
City:_____________________________________________________________________________________
State: ________________________________________________Zip Code:__________________________
Day Telephone #:__________________________________Night Telephone #:__________________
Email Address:___________________________________________________________________________
Check here to SHIP to above address: ____
SHIP TO: (complete if different than above)
Name: ___________________________________________________________________________________
Address:_________________________________________________________________________________
City:_____________________________________________________________________________________
State: ________________________________________________Zip Code:________________________
BILL TO:
Name:_____________________________________________________________________________________
Address:__________________________________________________________________________________
City:_____________________________________________________________________________________
State: ________________________________________________Zip Code:__________________________
Day Telephone #:__________________________________Night Telephone #:__________________
Email Address:___________________________________________________________________________
Check here to SHIP to above address: ____
SHIP TO: (complete if different than above)
Name: ___________________________________________________________________________________
Address:_________________________________________________________________________________
City:_____________________________________________________________________________________
State: ________________________________________________Zip Code:________________________
ORDERING INSTRUCTIONS:
Print out Order Form! Fill in Credit Card Information or Make Check or Money Order payable to
The Inner Light Shoppe. Then Mail this form to The Inner Light Shoppe (see additional
instructions below).
Paying By: (check one)
Money Order_____ Cashier Check_____ Personal Check_____ Credit/Debit Card_____
Paying by Credit/Debit Card:
Type of Credit/Debit Card: Visa_____ MasterCard____ American Express___ Discover Card____
Name on Credit//Debit Card:_____________________________________________________________________________________
Credit/Debit Card Number:______________________________________________________________________________
Expiration Date: ______________________ Security Code (last 3-Digits on Back of Card): ______________
Amount Charging to Credit/Debit Card: $____________________________
Signature of Person on Card:___________________________________________________________________________
Ordering By Mail:
Complete form with Credit/Debit Card information or make a Cashier Check, Personal Check
or Money Order payable to The Inner Light Shoppe then send to:
The Inner Light Shoppe
P.O. Box 214988
Auburn Hills, MI 48326
*Note: With every purchase there will be a one-time standard handling fee charge of $2.00 which will be
added to your Shipping Fee whether you buy one or many items. We only ship to the United States, its
Territories, and Canada.
FREE SHIPPING for retail orders $100 or more!
Shipping Fees Information Below:
Print out Order Form! Fill in Credit Card Information or Make Check or Money Order payable to
The Inner Light Shoppe. Then Mail this form to The Inner Light Shoppe (see additional
instructions below).
Paying By: (check one)
Money Order_____ Cashier Check_____ Personal Check_____ Credit/Debit Card_____
Paying by Credit/Debit Card:
Type of Credit/Debit Card: Visa_____ MasterCard____ American Express___ Discover Card____
Name on Credit//Debit Card:_____________________________________________________________________________________
Credit/Debit Card Number:______________________________________________________________________________
Expiration Date: ______________________ Security Code (last 3-Digits on Back of Card): ______________
Amount Charging to Credit/Debit Card: $____________________________
Signature of Person on Card:___________________________________________________________________________
Ordering By Mail:
Complete form with Credit/Debit Card information or make a Cashier Check, Personal Check
or Money Order payable to The Inner Light Shoppe then send to:
The Inner Light Shoppe
P.O. Box 214988
Auburn Hills, MI 48326
*Note: With every purchase there will be a one-time standard handling fee charge of $2.00 which will be
added to your Shipping Fee whether you buy one or many items. We only ship to the United States, its
Territories, and Canada.
FREE SHIPPING for retail orders $100 or more!
Shipping Fees Information Below:
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| All Rights Reserved Copyright 2009, The Inner Light Shoppe |
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| THE INNER LIGHT SHOPPE Your Internet Store of Unique Products for the Body, Mind & Spirit |