The Quiet Room Pagan Shoppe
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Order Form

Due to recent hackings on the Internet, including Microsoft's 'inner sanctum', and in an effort to protect our customers, we are taking only mail in orders. We feel this is the only safe way to do business at this time. Sorry for any inconvenience.

THE QUIET ROOM GIFT SHOPPE
100 Swift Blvd. Suite B-1
Goose Creek, SC 29445
(843) 824-9727
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Item # Description # ordered Price
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Subtotal $________
SC Residents add 6% sales tax: ________
Shipping 7% ________
Total: $________
Ship to:
Name: ______________________________________________________
Address: ___________________________________________________
City/State/Zip: ____________________________________________
Special instructions or comments:
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Money orders or bank drafts will be processed within 48 hours. Personal checks will be held for 30 days to allow bank clearance. Just print out order form, fill it in, and mail to the address above.



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