5022 Roy William Place
Louisville, KY 40228-1292
Company Phone # : 502-744-9261 * Fax Number: 502-742-3082 * sales@tonys-tot-town.com
Billing Info:
Shipping Info (if different than Billing):
Name:
Name:
Address
Address
City/St/Zip
City/St/Zip
Phone Number
Phone Number
Email Address
Email Address

Item(s)
Description
Quantity
Price Each
Total



Subtotal / Shipping Charge
$0 to $9.99 - $5.00
$10 to $49.99 - $11.00
$50 to $99.99 - $17.00
$100 to $199.99 - $28.00
$200 or more - $42.00
These shipping charges do not apply to the Baby Einstein products; Quilts By Donna Twin, Full/Queen, or King Quilts or Quilt Sets nor handbags; Shipping charges for these are :
Quilt only = $10.00 ; Quilt Set = $20.00
Baby Einstein = $5.00 each
Handbags = $6 for first, $4 each add. bag)
Subtotal __________________
KY add 3% only ____________
Shipping __________________
(See Chart at Left)
Total _____________________

Payment Information - Please Check One
Check______Money Order______Visa______MasterCard______Discover_____
Credit Card No._____________________________________Exp ___/___

Credit Cards will NOT be accepted from anyone under 18. All information is kept private and will NEVER be shared or misused. Please refer to http://www.tonys-tot-town.com/LegalPage.htm for additional details and privacy statements.
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