Mail/Fax in Order Form                             Cozycatz 

First Name

Last Name

Street Address

City

State/Province

Zip/Postal Code

Phone

E-mail
or Fax order to: 1-866-255-5070

ITEM
NUMBER

QTY

DESCRIPTION                                                       PRICE
  
Shipping Address: (if different than above)
Address     
 
City:                       State:   Zip/Postal Code:           

Credit Card Information : Visa Master Card
                                        Discover
    *PLEASE NOTE: CREDIT CARD BILLING ADDRESS MUST MATCH ORDER ADDRESS*

Name on Card

Card Number

Exp. Date

CVV Code

Copyright © 1999 Cozycatz. All rights reserved.
Revised: November 18, 2003

Please make Check or
Money Order payable to:

Cozycatz
P.O. Box 97895
Pittsburgh, PA
           15227

Please note, personal checks
require 7 to 10 business days
to clear before shipping.