WHOLESALE Order Form

Company Name __________________________________________________ Tax ID #________________________________

Ship To Address:_________________________________________________________________________________________

Phone _______________________________Fax: _______________________Email: _________________________________

Form of Payment in U.S. Dollars (check one):

____VISA     ____Mastercard     ____Check   ____ Money Order

Credit Card # ________________________________ Exp. Date ___________Name on Card ____________________________

Credit Card Bill To Address: ________________________________________________________________________________

Item #	Description	# of cases	Unit/case	Price/candle	Extended Price
________	_________________________	________X	________X	________=	________
________	_________________________	________	________	________	________
________	_________________________	________	________	________	________
________	_________________________	________	________	________	________
________	_________________________	________	________	________	________
________	_________________________	________	________	________	________
________	_________________________	________	________	________	________
________	_________________________	________	________	________	________
________	_________________________	________	________	________	________
________	_________________________	________	________	________	________
________	_________________________	________	________	________	________
________	_________________________	________	________	________	________
________	_________________________	________	________	________	________
				Shipping	________
				TOTAL	________

Unique Aromas 29 Mack Street Batesville, AR 72501 Fax #: 1-888-741-5931 Phone: 1-800-373-7210

Add 15% of total order for Shipping/Handling Large order will ship by American Freight Way , C&L Carrier, Yellow Freight or CSE trucking.

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