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!