ORDER FORM
Tangoleva 		ORDER BY PHONE:
ORDER BY FAX:
ORDER BY MAIL:
ORDER BY E-MAIL:
 Toll Free 877-92-TANGO (877-928-2646)
505-438-1170
1270 Calle de Commercio #5   Santa Fe, NM 87507 USA
INFO@TANGOLEVA.COM



Please print this form for use
with phone, fax, and mail orders.
BILLING INFORMATION     *required for credit card orders

NAME ________________________________________________

ADDRESS ____________________________________________

CITY, STATE, ZIP _______________________________________

PHONE  (HOME)_______________________ (WORK)______________________

EMAIL ________________________________________________

SHIP TO

NAME ________________________________________________

ADDRESS ____________________________________________

CITY, STATE, ZIP _______________________________________

PHONE  (HOME)_______________________ (WORK)______________________

EMAIL ________________________________________________ 

 
METHOD OF PAYMENT

__AMERICAN EXPRESS    __MASTER CARD
__VISA    __MONEY ORDER    __CHECK

ACCOUNT NUMBER

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__________________(MM/YY)
EXPIRATION DATE

__________________
3-DIGIT CODE (Last 3 digits found on the back of your card)

_______________________________________
SIGNATURE

ITEM #
DESCRIPTION
1ST COLOR CHOICE
2ND COLOR CHOICE
SIZE
PRICE
           
           
           
           
            
SHIPPING CHARGES                                          *EXPRESS DELIVERY
$0 - $25.00              $4.95
$25.01 - $45.00        $6.95                                     Next Day     ADD  $16.95
$45.01 - $75.00        $8.95                                     2nd Day      ADD   $11.95
$75.01 - $95.00        $10.95
$95.01 - $135.00      $12.95
$135.01 - $175.00    $14.95                                  *INTERNATIONAL SHIPPING
$175.01 - $250.00    $16.95
$250.01 - $380.00    $18.95                                          Please call or email for shipping costs.
OVER $380.00      5% of merchandise total
MERCHANDISE TOTAL  
SALES TAX
for NM only, add 7.313%		  
SHIPPING CHARGE  
EXPRESS DELIVERY  
TOTAL  

If you are not completely satisfied with your Tangoleva purchase, please return item(s) within 15 days of the delivery date for an exchange or refund. Place item(s) in a secure package, making sure it is insured, prepaid and has a tracking or delivery confirmation number.