The Netmall Order Form
Print this order form and mail with check (please allow 10 business days
for personal checks to clear), money order, or cashiers check to:
The Netmall
1558 Andover Dr.
Dunedin, Fl. 34698
Hurricane-Eye.Com, Time4Weather.Com, and H2ofilters.Com customers,
please make your checks out to 'THE NETMALL GROUP'

QTY. ITEM PRICE












SUB-TOTAL
Shipping
7% SALES TAX (Florida residents only)
TOTAL

Customer Information:

Customer Name ______________________________________________

Address ________________________________________________

City ___________________________________________________

Zip Code ___________________________________

E-mail Address ___________________________________

Phone Number (include area code) _______________________________

Shipping Information: (leave blank if same as customer address)

Name to ship to: _____________________________________________

Address____________________________________________________

City_______________________________________________________

State______________________________________________________

Zip Code____________________________________________________

Is this a gift? __ Yes __No

What would you like to say on the gift card?

__________________________________________________________


Credit Card Information:

Name on Credit Card _______________________________________

Type (we accept Visa, Mastercard, American Express, and Discover) _________________

Expiration Date ______________

Card Number _____________________________________________

Home Call toll free 1-877-760-3773 E-Mail Us