INNER JOURNEYS CRYSTAL & MINERAL EMPORIUM ORDER FORM
Use this version for printing out a blank order form for faxing or sending through the postal mail.Please read the General Ordering Instructions before submitting your order.
DO NOT SEND CREDIT CARD INFORMATION VIA E-MAIL!
Our 24-hour toll-free fax and voicemail number is 1-888-SOULPATH (1-888-768-5728). Our mailing address is:
INNER JOURNEYS
42222 50th St. W.
Quartz Hill, California 93536
USA
ORDERED BY:
Name : ___________________________________
Street Address: ___________________________________
: ___________________________________
City : ___________________________________
State : ___________________________________
Zip Code : ___________________________________
Country : ___________________________________
Email : ___________________________________
Phone : ___________________________________
SHIP TO: (if different from above)
Name : ___________________________________
Street Address: ___________________________________
: ___________________________________
City : ___________________________________
State : ___________________________________
Zip Code : ___________________________________
Country : ___________________________________
PAYMENT INFORMATION:
How would you prefer to pay for this order?
Personal Check___ Business Check___ Credit Card___
Type of Card: Mastercard___ Visa___ Discover___
Credit Card Information:
Your credit card will not be debited until your order ships.
Name (on your card) : ___________________________________
Credit Card # : ___________________________________
Expires? (mth/yr) : ___________________________________
ALL PRICES ARE QUOTED IN U.S. DOLLARS.
What item(s) would you like to order?
ITEM # DESCRIPTION PRICE
1. _______ __________________________ __________
2. _______ __________________________ __________
3. _______ __________________________ __________
4. _______ __________________________ __________
To order additional items, please use a separate sheet.
THANK YOU FOR YOUR ORDER!