Providence Spillproof
P.O. Box 40672
Providence, RI 02940
or Fax it with credit card information to us at: (401) 723-4937
Ship To:
NAME: ___________________________________________________________
ADDRESS:________________________________________________________
CITY: _____________________ STATE: ______ ZIP:_____________________
PHONE:____________________EMAIL ADDRESS: _____________________
Bill To: __
Same as Above
NAME:__________________________________________________________
ADDRESS:_______________________________________________________
CITY: ______________________ STATE: _______ ZIP: _________________
__
Enclosed is my check payable to Providence Spillproof Container
Charge to: __VISA, __MASTERCARD,
CARD NUMBER:_______________________________________________
EXPIRATION DATE: ________SIGNATURE_______________________
EACH
PRICE
MERCHANDISE TOTAL:
SHIPPING CHARGE :
6.00
TOTAL AMOUNT DUE:
3 of same size Nosey Cup - $9 One of each size Nosey Cup - $9
Ship - Priority Mail: $6
Please make checks payable to: Providence Spillproof Container
(888) 843-5287