Complete and submit your order using our ORDER FORM, or
Complete and print this form, then fax it to us toll-free at 1-(888) 710-8336, or
Phone in your order to (703) 339-6243
Note:
If you are uncomfortable using our Order Form, please fax us your information or call us with your order.
All information will be held in the strictest confidence. We will not release your information to a third party without your expressed permission.
How did you learn about the Lee Johnson Group:
Charge Card Payment Information:
Name on card:
Billing Address:
City:
State:
Zip Code:
Country:
Credit Card:
MasterCardVisaAmerican ExpressDiscover
Credit Card #:
Expiration Date:
Item Name:
Quantity:
Unit Price:
Item Name:
Quantity:
Unit Price:
Total Due:
Please be sure to include shipping and handling fees listed below and appropriate sales
tax.
* Virginia state residents will be charged 4.5% sales tax.
Orders are charged the following handling fees:
Orders up to $99.00:
$25.00
Orders $100.00-$499.00:
$35.00
Orders $500.00 to $1,000.00:
$45.00
Orders $1,000.00 and above:
$45.00 plus 3% of total sale
Please note:
Orders requesting overnight delivery must double the
handling fees listed above.