*Please print, fill out and fax or mail back.
William Carl Bell
Order Form
510 Lakewood Drive
Sumter, South Carolina 29150
Phone: (803) 481-0884 Fax: (803) 481-0854
Date of Order:
Name:
Address:
City: State: Zip:
Phone Number: Email Address:
Item Name Quantity Price
(Ex. "Stately Trio")
Merchandise
We gladly accept the following Shipping (Please call)
credit cards Sub Total
Tax
AMOUNT DUE
Credit Card Expiration Date
Account # Signature
William Carl Bell
Order Form
510 Lakewood Drive
Sumter, South Carolina 29150
Phone: (803) 481-0884 Fax: (803) 481-0854
Date of Order:
Name:
Address:
City: State: Zip:
Phone Number: Email Address:
Item Name Quantity Price
(Ex. "Stately Trio")
Merchandise
We gladly accept the following Shipping (Please call)
credit cards Sub Total
Tax
AMOUNT DUE
Credit Card Expiration Date
Account # Signature
