Order Fax Form-Fax number is 919-336-3157


BrassBell.com
118 International Drive, Suite 110
Morrisville, NC 27560
1-866-417-2355 (toll-free)
919-336-3154 (direct)
919-336-3157 (fax)
customerservice@brassbell.coom
 
Qty Name of Item Price of Item Personalization
(as seen on website) (as seen on website) (if applicable)
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Bill To: Ship To: (If same as Bill To, please write 'Same')
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Customer Info:
Telephone Number: ____________________________
   
Email Address: ________________________________
   
Credit Card Info:
Credit Card Type: _____________ Card #: _______________________________Exp: _________
   
Name on Card: ___________________________ Security Code: _________
 
Your Signature: ___________________________________________________
 
 
Special Instructions: