Hookah Order Form - Printable Online Order Form At SouthSmoke.com


		Order 24 hours a day www.southsmoke.com Order by phone 1.888.577.6653 Fax 305.402.2300

BILL TO		SHIP TO (if different from "Bill To")
NAME		NAME

ADDRESS		ADDRESS

CITY		CITY

STATE ZIP		STATE ZIP

Please provide any discount or gift card code that you may have received below:		We will need both your phone number and email address in case we have questions about your order.
DISCOUNT CODE		PHONE EMAIL

ITEM#

ITEM DESCRIPTION

SIZE

COLOR

QTY

UNIT PRICE

TOTAL PRICE

METHOD OF PAYMENT
Please enclose your personal check, money order, or credit/debit card infomation.

We accept most major credit/debit cards:
___American Express ___Discover Card ___Visa ___MasterCard ___Visa Debit ___MasterCard Debit

CARD#__________________________________________

Expiration Date ____________

Authorized Signature (required)

________________________________________________



SUBTOTAL

ADD SALES TAX For FL, NC shipping, please add applicable local and state sales tax

SHIPPING CHARGES per address For our current shipping charges, click here.

GRAND TOTAL


ORDER BY PHONE Call Toll Free 1.888.577.6653	FAX YOUR ORDER Fax this order form to 305.402.2300	MAIL-IN YOUR ORDER Please contact SouthSmoke.com to first place your order via telephone.
THE SOUTHSMOKE.COM GUARANTEE We guarantee your satisfaction! Our goal is to provide you with everything you need for your Hookah smoking pleasure. If you are not satisfied with your purchase, please contact us with 72 hours from the time of delivery and we will be glad to assist It's that simple!