| SILLY TOWN
FAX ORDER FORM Please print this form, complete information and fax to 303-296-8366. Please print legibly. You will receive a conformation/receipt of your order via email. Name:___________________________________Company:_________________________ Address:________________________________________________ City, State, Zip:________________________, ________, ________Country:___________ Daytime Phone:___________________________Email:____________________________ Credit Card Type, Number and Expiration Date: (Visa, MC, Discover, Amex) Type:________#:__________________________________Exp.:________ Name on card:___________________________________________ Billing Address:(if different from above)__________________________________________ City, State, Zip:________________________, ________, ________Country:___________ Color in
the box on the left, next to the products you would like to order and |