Layaway Order Form

Please print out and Mail or Fax the following Layaway Request. We will then provide you with a Layaway Agreement based on your desired payment schedule.
Description, Color, Size	Style No.	Quantity	Unit Price	$ US
1.			$	$
2.			$	$
3.			$	$
4.			$	$
5.			$	$
Include Shipping here >>>>				$
U.S. SHIPPING: Standard Ground $15.99, UPS 3 Day Select $22.99, UPS 2nd Day Air $32.99, U.S.P.S. Express $36.99, UPS Next day Saver $44.99, UPS Next day air $54.99 INTERNATIONAL: U.S. Air Parcel Post $24.99 to Canada, $49.99 Global Express for all other International destinations
Total Due >>>> (total amount that will be paid by end of layaway agreement )				$

Duration of Layaway Plan
(please check one)

1 month billed in 4 weekly installments

2 months billed in 4 bi-weekly installments

3 months billed in 3 monthly installments

6 months billed in 6 monthly installments

12 months billed in 12 monthly installments

Custom Plan __ weeks billed in __ weekly installments

Custom Plan __ months billed in __ monthly installments

*Please keep in mind that construction on corsets does not begin until final payment is made.

Layaway Payments will be made via ... (please check one) Credit Card Personal Check Money Order
Where would you like us to send your Layaway Agreement? (please check one) Please E-mail it to me at _________________________ Please Fax it to me at the following number _____________________ Please send it to me at the following mailing address __________________________ _______________________________________________________________________
Customer Information
Full Name:	Telephone:
Street or P.O. Box Address:	E-Mail Address:
City: State: Zip:	Country:
	<<<< Provide any special Instructions or requests