Refreshingly Free
www.RefreshinglyFree.com
Phone: (336) 510-0585  Fax: (336) 510-1462
1
866 Acorn Drive, Randleman, NC 27317
sales@refreshinglyfree.com
Natural and Fragrance Free Products
Printable Order Form
Ship To Address
Bill To Address
Name  ________________________________________________
Name  ____________________________________________
Address  _____________________________________________
Address  __________________________________________
City _________________________
State _______
Zip __________
City _________________________
State _______
Zip __________
Phone ____________________
Visa
Master Card
Money Order
Discover
Gift Certificate
American Express
**We are unable to accept personal checks at this time.
Expiration
Date
Card #
Cardholder Signature
(As it appears on the card)
Quantity
Product
Number
Product Description
Unit Price
Total Price
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
Merchandise SubTotal:     
 
Tax (NC Addresses add 7.5%):     
 
Shipping Charge (see chart below):     
 
Total Due:     
 
(East of the
Mississippi River)*
Shipping

Charges
Charges
 
Details
$0.00 - $4.99
$4.00
  *States West of the Mississippi River - $1.00 will be added to the charge, only $.50
will be added for up to $4.99
$5.00  - $15.00
$5.95
  **  Free shipping orders:  will be sent via Ground service but if it exceeds 15 pounds,
it will be subject to freight charges.
$15.01 - $30.00
$6.95
  Alaska/Hawaii Orders:  will be based on the weight of the order and will be shipped via
USPS Parcel Post service unless you select Priority Mail where additional charges will apply.
$30.01 - $45.00
$7.95
  Canadian Orders:  Will be based on the weight of the order and will be shipped via
Airmail Parcel order and will be shipped via Airmail Parcel Post - please contact us
(336) 510-0585.
$45.01 - $60.00
$8.95
  Priority Mail - 2-4 days delivery to the contiguous 48 states - add $4.00.
$60.01 - $75.00
$9.95
  Bulk Order (those > 15 pounds) - will be charged actual weight based shipping charges
to your destination via the least expensive method. These charges may be added after you
order, but you will be notified if the adjustment is over $7.00 of the original shipping charges
- please contact us at (336) 510-0585 if you have questions.
$75.00 - $100.00
$11.95
   
$100.01 - $125.00
$13.95
   
$125.01 - $150.00
$15.95
   
>   $150.01
FREE **
 
See our online terms of service page for more information:
http://www.refreshinglyfree.com/terms_of_service.html


CUSTOMER INFORMATION
Phone_______________________
Email_______________________

Country ____________________
PAYMENT METHOD