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TEDDY BED® BUY-DIRECT ORDER FORM

Complete the form below then print this form and mail it with your check.

For orders or customer service inquiries, or if you are a retailer who wants to order in quantity,
call us for pricing at 1-503-325-4802, between 8 a.m. and 5 p.m., Pacific Standard Time.

Bill-To Name
Street
City, State, Zip
Area Code & Phone
E-Mail Address
Please retype e-mail address to confirm.

Item # Color Description Quantity Total
Price




Total Cost of Items
Shipping & Handling $4.95
Total due for this order. (Make check payable to Premarq, Inc.)

If paying by check, please make your check or money order payable to
Premarq, Inc., and mail it with this form to 89529 Green Mountain Road, Astoria, OR 97103.

After we receive your order and payment, we will send your items within 10 business days.

Teddy Bed® is a registered trademark of and is manufactured by
Premarq, Inc., 89529 Green Mountain Road, Astoria, OR 97103.

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