Degloss.com
Order Form
Fill out the form below, then print and sign it before sending by FAX or mail.
Billing Address
Shipping Address
Same as Billing Address
First Name
First Name
Last Name
Last Name
Address
Address
Apt./Unit
Apt./Unit
City
City
State/Prov.
State/Prov.
Zip/Postal
Zip/Postal
Country
Country
Phone
Phone
E-mail
E-mail
Description
Shade
QTY
Price
Each
Total
Light
Medium
Tan
Matt's
Original
Deglosser
$6.95
Executive
Matt
$6.95
Postage & handling
$2.50
WI residents
add 5.5% sales tax
Total
Charge my
VISA
Master Card
Card No.
-
-
-
Expiration Date
/
Signature
(Please sign after printing order form)