Order by Fax:
24hrs/day 7 days/week
Fax: 413-283-9377

Order On-line:
www.inexpensivescrubs.com

Order by Mail:
Inexpensive Scrubs
P.O. Box 713
Palmer, MA  01069-0713
Order by Phone:
Phone: 413-283-9377
NOTES: Please make checks payable to "TLC Enterprises".
Orders by personal check will be delayed up to 7-10 days for clearance.

BILL TO ADDRESS:

Name: ______________________________

Street: ______________________________

City: ________________________________

State/Zip: ___________________________

Phone #: (_____) _____________________

Fax #: (______) _______________________

E-Mail: ______________________________

SHIP TO ADDRESS:
(if different from Bill To Address)

Name: ________________________________

Street: ________________________________

City: __________________________________

State/Zip: _____________________________

Phone #: (_____) ________________________

E-Mail: ________________________________


Item # and Description
Color
Size
 Quantity Price Ea    Total   
           
           
           
           
           
           
           
           
           
           
___ VISA ___ Mastercard ___ Am. Exp.
___ Check ___ Money Order

Card #: __________________ Exp. Date: __________

Signature (required for all cards): _________________

NOTE:Please make checks payable to "TLC Enterprises"
Subtotal: 
  
Sales Tax: 
  
Shipping & Handling: 
  
Insurance:
  
Grand Total: