Order Form
~Dallas' Magic Shop~
Note: No Refunds!
Name: _____________________________
Date: ______________________________
Address: _______________________________________________
_______________________________________________
Email: _____________________________
Phone #:( )
- _______ - ________
Items: Quantity: Price:
- ____________ 1. ________ 1. ___________
- ____________ 2. ________ 2. ___________
- ____________ 3. ________ 3. ___________
- ____________ 4. ________ 4. ___________
- ____________ 5. ________ 5. ___________
{If any more items, please
write on the right side of this paper}
Shipping Charge: {circle one}
Under $30.00 à $5.00
$30.00 or higher à FREE
COUPON CODE {Optional}: _____________________
TOTAL $ {including shipping charge} :
Send order form and $ to:
Dallas White
3935 Southview Court
Jefferson, MD 21755
Thanks,
{Magician}
Dallas
White
