Printable Order Form
 (for Hombre Leather and Victoria A)

Just fill in all of the details, print the form. Sign it and mail it with your payment addressed to Hombre Leather, 2624 Bellevue Way NE, Bellevue, Washington 9800 USA. All checks should be made payable to Hombre Leather. If payment is by credit card you can, fax your order to (USA) 1-(425)-827-9248

We can only process orders if the name and address entered below are those of the credit card holder. The address must be the same as the billing address used for the credit card selected. All information is kept confidential and only used for verification of credit card's authenticiy and then delivery of products/services. You will NOT be put on a mailing list.

Billing Information

Your Name as shown on Card Required - as shown on card. 
Address Required.
Address
City
State/Province 
Zip/Post Code Required.
Country Required.
Email Required.
Fax If you request Fax confirmation

Items Ordered

Item  Select those Items You wish to order now.  Charge 
Garment or Accessory Type US$
Duplicate Items Duplicates Of One Items: Indicate Number And Cost  Add Extra Item Shipping @ $  each.  US$
Mode of Delivery (U.S.A. Only!)  US$
Custom Design Service US$
Other Specifications US$
Subtotal Subtotal US$
Sales Tax California Residents add 7.75% State Tax US$
Grand Total Amount to be charged Required___Grand Total US$

Payment

Please select your credit card from the list below. Hombre Leather is pleased to be able to offer payment by credit card for all orders, regardless of country of origin. All card transactions are billed in US dollars by our Bellevue office.  
Payment by
Card Number Required - Eg. 5555 5555 5555 5555
Valid From If available
Expiry Date Required - Eg. 5/97

I hereby waive any and all claims against Hombre Leather, its employees and directors. I hereby authorize Hombre Leather to debit my credit card for the amount shown above. 



I understand and agree with the above.  Please process my order, 
charging my credit card for the above total amount.



Signed ______________________________



Dated________________

After completing the above, print out the order, sign and date it, and mail it
to Hombre Leather, 2624 Bellevue Way NE, Bellevue, Washington 98004 USA.
All checks should be made payable to Hombre Leather. If payment is by credit
card you can, fax your order to (USA) 1-(425)-827-9248. Credit card bills will say
"Hombre Leather"

Any Questions? Please contact [email protected]