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Candle Decor

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Candle Reply Form

PLEASE FILL IN ALL DATA SO WE CAN RESPOND
 FIRST NAME
LAST NAME
ADDRESS1 
  ADDRESS2   
    CITY        
PROV/STATE POSTAL CD/ZIP
EMAIL PHONE       

Indicate your Purchases and payment method below


Payments can be made by VISA, MASTERCARD, check, money order, or direct deposit to the Royal Bank:
account # 01312 003 7309974

Candle Gel ?
High polymer
Medium polymer
 Payment method
Check
Money order
Direct deposit
VISA
MASTERCARD

Please list your purhases and costs in the following area.
We will email you to confirm the order and add in the shipping costs.






IF YOU HAVE ANY PROBLEMS WITH THIS FORM... SEND A REGULAR EMAIL!
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