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Order Form

Fax / Mail Order Form (Requires Printer)
To Print this form, use your browser's "print" button.
Please, make checks payable to J. Russell Salons
and mail with the Order Form for fulfillment to:

J. Russell Salons
The Gardens of the Palm Beaches
3101 PGA Boulevard, Suite J-201
Palm Beach Gardens, Florida 33410
Email: info@jrussellsalons.com

PLEASE NOTE: Shipping is delayed on orders payed by check until the check clears our bank.

If you wish to pay by credit card, follow directions below.
Please, accept my order (Delivery Time 5-6 Business Days) for:
PLEASE NOTE: Shipping is delayed on orders payed by check until the check clears our bank.
Description Item Quantity Unit Price Total $ US
1. # : $ $
2. # : $ $
3. # : $ $
4. # : $ $
5. #   $ $
6. #   $ $
7. #   $ $
8. # : $ $
Sub-Total $
Shipping & Handling (See chart below) $
Florida Sales Tax 6% (If applicable) $
TOTAL DUE (Charge Amount) $

SHIPPING & HANDLING:
$0.00 to $39.99 ..................................................................................................................... $4.95
$40.00 to $64.99 ................................................................................................................... $5.50
$65.00 to $99.99 ................................................................................................................. $10.50
$100.00 to $149.99 .............................................................................................................. $14.00
$150.00 to $200.00 .............................................................................................................. $20.00
$200.00 and up ......................................................................................by weight minium $25.00
email us for S&H charges outside of Continental U.S.
Please, provide sufficient information so that we can properly process your order.
First Name  
Last Name  
Company  
Street or P.O. Box  
City  
State  
Zip  
Country  
Telephone  
FAX  
E-Mail Address  
PAYMENT INFORMATION:
We accept Visa, Mastercard, American Express and Discover Card;
or mail your Check / Money Order payable to:

J. Russell Salons
The Gardens of the Palm Beaches
3101 PGA Boulevard, Suite J-201
Palm Beach Gardens
Florida 33410

Toll Free: 1-877-701-1477
Phone: 561-775-0704
Fax: 954-349-3978

If you are paying by credit card, you may send your order by fax or mail. Our fax number is: 954-349-3978. For additional information, please telephone: 561-775-0704
Cardholder Name  
Credit Card Number [Visa, MC,
Discover, Amex]		  
Expiration Date  
Signature (FAX or Mail Orders):
Comments & Notes:

Thank You for Your Order! 

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