Mail / Fax Order Form

We recommend online ordering for quickest processing. Please use this form only if you do not wish to place your order electronically. After filling out this form you will need to print it and mail it to us with your full payment enclosed. If you are paying via Visa or MasterCard you may submit this form via mail or fax. We'll ship your order as soon as payment is received and processed. We accept Checks, Money Orders, Visa, and MasterCard as payment for mail and fax orders.

If you have any questions or concerns about ordering please contact our Customer Service at custserv@fluppiusa.com.

Original Fluppi is Discontinued. Alternate item in Red or Blue is available.

Product:

Product	* (for other quantities or express shipping e-mail sales@fluppiusa.com for a quote)
Color	Red Blue See Special Instructions (red and blue are an alternate item)

Shipping Address:

Name	*
Address	*
City	*
State	*
Zip Code	*
Phone
Email	*

Billing Address (if different):

Name
Address
City
State
Zip Code
Phone
Email

Payment / Notes:

Payment Choice	*
Special Notes / Instructions

By printing your order you understand that:

Payment must be received in full before we ship your order.
Credit card orders must include billing address (where bill for the card is received).
We are not responsible for payments that are lost in the mail.
We may choose to wait for your payment to clear before shipping your order.
All fields followed by '*' are required for us to process your order.
If you do not provide a contact number or e-mail we will not be able to contact you if issues arise.

Fax this form to (866) 242-0083 (credit card payment only) or mail along with your full payment to:

FluppiUSA
P.O. Box 22234
San Francisco, CA 94122

P.O. Box 22234
San Francisco, CA 94122
Fax: (866) 242-0083

Information:
Volume orders:
Customer service:
Webmaster:

info@fluppiusa.com
sales@fluppiusa.com
custserv@fluppiusa.com
webmaster@fluppiusa.com

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