Shoe Cover Dispensers

“Professional Products as Easy to Use as 1·2·3”

Order Form

These products are available for online ordering and IMMEDIATE DELIVERY!
(please allow 5-7 days for shipping)

Product Selection:
QTY:	ITEM:	PRICE:
	Portable Shoe Cover Dispenser Color: Silver	$69.99 + S/H
	Shoe Covers (10 per pack) For Portable Dispenser	$1.50 + S/H
	Automatic Shoe Cover Dispenser Color: White	$1595.00 + S/H
	Shoe Covers (200 per pack) For Automatic Dispenser	$25.00 + S/H

	Product Sub-Total:	$0.00 + S/H

Shipping Information:
Name:
Address:
City:
State:
Zip:
Country:

Phone:

Email: (Receipt & Order Information will be sent via email)

Billing Information:
Credit Card Type:
Credit Card #:
Expiration Date:	(MM/YY)
Name: (as it appears on the card)
	Check Here if the shipping & billing addresses are the same
Address:
City:
State:
Zip:
Country:

Phone:

Email: (Receipt & Order Information will be sent via email)

(clicking "Continue to Order Confirmation" does not submit your order, but takes you to an overview page, allowing you to review your order information before placing the order)