Please print and mail. Call for address
or click the "contact us" link to scan and
email your order.
or click the "contact us" link to scan and
email your order.
Salt Rock Creations
908-2265-5566 Betthom@comcast.net
Order Form
Description Qty. Price Each Subtotal
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Total Purchase_________
Sales Tax (7%)________
Delivery (Local Only) $5.00
Total Amount_________
Please call to view our products in person!
___ Local delivery (allow 2 weeks; for less time please call)
___Shipping (please inquire)
Name (print) (Required)
______________________________________________
Address
______________________________________________
Phone(s) (Required)
______________________________________________
(Orders paid by check will be mailed 3 days after receipt of the
check).
Referred by: ____________________________________
E-mail us at: Betthom3@verizon.net for further information.
All products are guaranteed, Product exchange only
Product color will vary due to natural varied mineral content
Call: 908-226-5566 for mailing information
___ Yes, I am interested in having a home party and earning
free salt rock/candle products and /or discounts!
Thank You!
908-2265-5566 Betthom@comcast.net
Order Form
Description Qty. Price Each Subtotal
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Total Purchase_________
Sales Tax (7%)________
Delivery (Local Only) $5.00
Total Amount_________
Please call to view our products in person!
___ Local delivery (allow 2 weeks; for less time please call)
___Shipping (please inquire)
Name (print) (Required)
______________________________________________
Address
______________________________________________
Phone(s) (Required)
______________________________________________
(Orders paid by check will be mailed 3 days after receipt of the
check).
Referred by: ____________________________________
E-mail us at: Betthom3@verizon.net for further information.
All products are guaranteed, Product exchange only
Product color will vary due to natural varied mineral content
Call: 908-226-5566 for mailing information
___ Yes, I am interested in having a home party and earning
free salt rock/candle products and /or discounts!
Thank You!
Ordering methods:
1. Click the "contact us" link at right to e-mail
your order.
2. Print and mail this form. (Call for address).
2. Call us to place your order and make
payment. Orders may be placed on the
answering service. We will contact you for
credit card information.
We accept Checks, money orders.
Address and phone numbers are required
for deliveries and shipping.
1. Click the "contact us" link at right to e-mail
your order.
2. Print and mail this form. (Call for address).
2. Call us to place your order and make
payment. Orders may be placed on the
answering service. We will contact you for
credit card information.
We accept Checks, money orders.
Address and phone numbers are required
for deliveries and shipping.
Salt Rock Creations
908-264-9107 Betthom@comcast.net
Order Form
Description Qty. Price Each Subtotal
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Total Purchase_________
+ Sales Tax (6%)________
+ Delivery $2._________
= Total Amount_________
Please call to view our products in person!
___ Local delivery (allow 1 week, for less time please
call)
___Shipping (please inquire)
Name (print)
____________________________________________
Address
____________________________________________
Phone(s)
____________________________________________
Method of Payment: (You can also call in your CC
number)
__ Check__ Credit Card
Credit Card Info:
Card Type: ____ Visa ____ Master Card
Name on Card (print)
____________________________________________
Card Number
____________________________________________
Exp Date:
____________________________________________
__
Card Holder Signature
____________________________________
Thank You!
Referred by:
___________________________________
908-264-9107 Betthom@comcast.net
Order Form
Description Qty. Price Each Subtotal
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Total Purchase_________
+ Sales Tax (6%)________
+ Delivery $2._________
= Total Amount_________
Please call to view our products in person!
___ Local delivery (allow 1 week, for less time please
call)
___Shipping (please inquire)
Name (print)
____________________________________________
Address
____________________________________________
Phone(s)
____________________________________________
Method of Payment: (You can also call in your CC
number)
__ Check__ Credit Card
Credit Card Info:
Card Type: ____ Visa ____ Master Card
Name on Card (print)
____________________________________________
Card Number
____________________________________________
Exp Date:
____________________________________________
__
Card Holder Signature
____________________________________
Thank You!
Referred by:
___________________________________
Order Form
Salt Rock Creations
908-264-9107 Betthom@comcast.net
Order Form
Description Qty. Price Each Subtotal
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Total Purchase_________
+ Sales Tax (6%)________
+ Delivery $2._________
= Total Amount_________
Please call to view our products in person!
___ Local delivery (allow 1 week, for less time please
call)
___Shipping (please inquire)
Name (print)
____________________________________________
Address
____________________________________________
Phone(s)
____________________________________________
Method of Payment: (You can also call in your CC
number)
__ Check__ Credit Card
Credit Card Info:
Card Type: ____ Visa ____ Master Card
Name on Card (print)
____________________________________________
Card Number
____________________________________________
Exp Date:
____________________________________________
__
Card Holder Signature
____________________________________
Thank You!
Referred by:
___________________________________
908-264-9107 Betthom@comcast.net
Order Form
Description Qty. Price Each Subtotal
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Total Purchase_________
+ Sales Tax (6%)________
+ Delivery $2._________
= Total Amount_________
Please call to view our products in person!
___ Local delivery (allow 1 week, for less time please
call)
___Shipping (please inquire)
Name (print)
____________________________________________
Address
____________________________________________
Phone(s)
____________________________________________
Method of Payment: (You can also call in your CC
number)
__ Check__ Credit Card
Credit Card Info:
Card Type: ____ Visa ____ Master Card
Name on Card (print)
____________________________________________
Card Number
____________________________________________
Exp Date:
____________________________________________
__
Card Holder Signature
____________________________________
Thank You!
Referred by:
___________________________________
Salt Rock Creations
908-264-9107 Betthom@comcast.net
Order Form
Description Qty. Price Each Subtotal
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Total Purchase_________
+ Sales Tax (6%)________
+ Delivery $2._________
= Total Amount_________
Please call to view our products in person!
___ Local delivery (allow 1 week, for less time please
call)
___Shipping (please inquire)
Name (print)
____________________________________________
Address
____________________________________________
Phone(s)
____________________________________________
Method of Payment: (You can also call in your CC
number)
__ Check__ Credit Card
Credit Card Info:
Card Type: ____ Visa ____ Master Card
Name on Card (print)
____________________________________________
Card Number
____________________________________________
Exp Date:
____________________________________________
__
Card Holder Signature
____________________________________
Thank You!
Referred by:
___________________________________
908-264-9107 Betthom@comcast.net
Order Form
Description Qty. Price Each Subtotal
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Total Purchase_________
+ Sales Tax (6%)________
+ Delivery $2._________
= Total Amount_________
Please call to view our products in person!
___ Local delivery (allow 1 week, for less time please
call)
___Shipping (please inquire)
Name (print)
____________________________________________
Address
____________________________________________
Phone(s)
____________________________________________
Method of Payment: (You can also call in your CC
number)
__ Check__ Credit Card
Credit Card Info:
Card Type: ____ Visa ____ Master Card
Name on Card (print)
____________________________________________
Card Number
____________________________________________
Exp Date:
____________________________________________
__
Card Holder Signature
____________________________________
Thank You!
Referred by:
___________________________________
Salt Rock Creations
908-264-9107 Betthom@comcast.net
Order Form
Description Qty. Price Each Subtotal
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Total Purchase_________
+ Sales Tax (6%)________
+ Delivery $2._________
= Total Amount_________
Please call to view our products in person!
___ Local delivery (allow 1 week, for less time please
call)
___Shipping (please inquire)
Name (print)
____________________________________________
Address
____________________________________________
Phone(s)
____________________________________________
Method of Payment: (You can also call in your CC
number)
__ Check__ Credit Card
Credit Card Info:
Card Type: ____ Visa ____ Master Card
Name on Card (print)
____________________________________________
Card Number
____________________________________________
Exp Date:
____________________________________________
__
Card Holder Signature
____________________________________
Thank You!
Referred by:
___________________________________
908-264-9107 Betthom@comcast.net
Order Form
Description Qty. Price Each Subtotal
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Total Purchase_________
+ Sales Tax (6%)________
+ Delivery $2._________
= Total Amount_________
Please call to view our products in person!
___ Local delivery (allow 1 week, for less time please
call)
___Shipping (please inquire)
Name (print)
____________________________________________
Address
____________________________________________
Phone(s)
____________________________________________
Method of Payment: (You can also call in your CC
number)
__ Check__ Credit Card
Credit Card Info:
Card Type: ____ Visa ____ Master Card
Name on Card (print)
____________________________________________
Card Number
____________________________________________
Exp Date:
____________________________________________
__
Card Holder Signature
____________________________________
Thank You!
Referred by:
___________________________________
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