Order Form

Please print this form, fill out all fields then fax your order to JVA Business Services. Thank you for using the JVA Business Services web site to place your order.

Unless you are sending in a check or attaching camera ready art, it is preferred that you fax this form to us at (510) 795-8164.

Company Name:	Date:
Address:	Phone:
	Fax:
	Contact:

Purchase Order #:_____ Mfg. Name:_____

Terms: 60% with Order/Balance COD

Quantity	Description	Price	Amount
	Style:
	Description:



	Special Instructions:



	Event Date: Need By:

	Item Color:
	Imprint Color:



	Art/Set-Up/Other Charges (Itemize)



	Subtotal

	Tax
	Rush
	Estimated Shipping
	Total
	Deposit
	Balance Due

JVA Business Services 2450 Peralta Blvd. Suite 100 Fremont, CA 94536 (510) 745-1844 Fax: (510) 795-8164	Credit Card #: ________________________ Exp. Date:_____________ Security Code: ___________ Signature: _________________________