SintheteX ::: Retail Order Form

Please fill in the form below

*= indicates required field

First & Last Name*:
Shipping address*: please include country and postal code
Billing address check here if same as above
Telephone number*:
Fax number:
Email Address*:

For each item you wish to order, enter quantity, size, item number, description, and price in the box below. You can copy and paste from the pricelist for this purpose. List each item on a separate line.*

QTY

SIZE

ITEM #

Description

PRICE

NOTE: Minimum order is $50, orders less than $50 will be charged a $10 handeling fee.

Please select your intended payment method:

Note: payment instructions will be provided after you click submit.

Yes, No, please add me to your mailing list

SintheteX respects your privacy and will never sell or exchange your email address.

please press submit only once
or reset to clear the form and start over

Clothing and Site Design Copyright Sinthetex 2000-2004, Images Copyright Sinthetex and/or the Credited Photographers