Page 1/2                 NYSTYLE FAX ORDER FORM

Fill out this form and fax or mail to:

NYSTYLE, Inc., 300 West 12th St, Suite 3I, NY,NY,10014

To:   NYSTYLE

Fax:  1.212.741.2640          Tel: 1.212.633.0165
____________________________________________________________________

From: ______________________    Date:_______________________________

Fax:  ______________________    Tel: _______________________________

____________________________________________________________________

Member ID:(current members) ________________________________________

BILL TO INFORMATION:

Name:_______________________________________________________________

Company:____________________________________________________________

Address:____________________________________________________________

City:___________________  State:______   Zip Code: _________________

Telephone: Day:(______)__________________ Eve: (____)_______________

Fax #:(_____)_____________________  Country:________________________

SHIP TO INFORMATION: (if different from Bill To e.g. a gift)

Name:_______________________________________________________________

Company:____________________________________________________________

Address:____________________________________________________________

City:___________________  State:______   Zip Code: _________________

Country:____________________________________________________________


Your email address: (reqd):_________________________________________

CREDIT/PAYMENT INFORMATION

Payment Type:___ Amex ___Visa ___ Mastercard ___Check ___Money Order

Credit Card Number: ________________________________________________

Name on card: ______________________________________________________

Expiration date: ___________________________________________________


____________________________________________________________________








Page 2/2                         ORDER DETAILS
                                 -------------
____________________________________________________________________
ORDER DETAILS:

If this is a gift, please enter your message below:



____________________________________________________________________

If the item to order requires additional choices or customized options,
enter these in the Description/Options box.
___________________________________________________________________________

Qty   Product#   Description/    Color   Size  Price   Shipping Total
                 Options
___________________________________________________________________________
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
_____|_______|__________________|______|______|______|_________|___________
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
_____|_______|__________________|______|______|______|_________|___________
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
_____|_______|__________________|______|______|______|_________|___________
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
_____|_______|__________________|______|______|______|_________|___________
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
_____|_______|__________________|______|______|______|_________|___________
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
     |       |                  |      |      |      |         |
_____|_______|__________________|______|______|______|_________|___________


						TOTALS         |___________
						TAX (NY-ONLY 
						x 8.25%)       |___________

                                                GRAND TOTAL    |___________