Telephone Orders: Call Toll Free (800) 551-4FUN. 
Have your Visa, Mastercard, Discover, 
or American Express ready.

Fax Orders: (858) 793-0747

Postal Orders: Chair Dancing® International, Inc. 
	      2658 Del Mar Heights Road 
	      Del Mar, CA 92014
Make Checks or Money Orders payable to Chair Dancing®

Email Address: orders@chairdancing.com
		


 
Item # Description Color Size Unit Price Quantity Subtotal
             
             
             
             
             
             
             
Tax  
Shipping  
Total  
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All Information submitted is kept 100% private. 

First Name _______________________________________________________
Last Name ________________________________________________________
Shipping Address _________________________________________________ 
Shipping City ____________________________________________________ 
Shipping State/Province ___________ Shipping ZIP Code ____________
Shipping Country _________________________________________________ 
Phone ________________________ Fax _______________________________
E-mail ___________________________________________________________ 

Credit Card Information.

Full Name as it appears on Credit Card 
__________________________________________________________________ 
Billing Address __________________________________________________ 
Billing City _____________________________________________________ 
Billing State/Province ______________ Billing ZIP Code ___________
Billing Country __________________________________________________  
Card Type ________________________________________________________ 
Card Number ______________________________________________________ 
Expiration _______________________________________________________