Order Form

Key Code:_____________

MAIL / FAX
ORDER FORM

Alecandy Corp.
376 Bay Ridge Ave.
Brooklyn, NY 11220

Fax (718) 492-2959

Tel: (646) 643-8688
www.alecandy.com

Bill To: Ship To: (if difference)

Name:		Name:
Address:		Address:

City, State ZIP:		City, State ZIP:
e-mail:		e-mail:
Phone:	( )	Phone:	( )

Order: (Date: ____/____/____)

Item #		Item Description	Qty.	Unit Price	Total
				$	$




Shipping / Handing				Sub-Total:
Up to $24.99	$4.00			Shipping:
$25.00 to $49.99	$6.00	Resident of New York add 8.25% Sales Tax		Tax:
$50.00 and over	FREE			Total:	$

Payment Info: Note: These are the only forms of payment we accept.

Visa Card	Master Card	American Express	Money Order / Check

---------------------------------------------------------- Card Number -------------------------------------------------

Exp. Date

_______________________________________________
Signature of Cardholder…must match "Bill To" name above.

I authorize Cycle Stuff USA to charge the credit card number indicated above for the total above plus sales tax (if applicable). I certify that the credit card number and signature above agree to the "Bill To" name above and that, as such, I am an authorized signer on this card.