2401 El Pavo Way
Rancho Cordova, CA 95670
(916) 361-3062
Please fill out and Fax to (916) 290-0387
Reservation/Credit Card Authorization Form
| Event Date: | _________________________ | Event Type: | ___________________________________ |
| Please check here if ordering Chair Cover and Sash Sample Only:______ $20.00 (a $10.00 credit will apply to your order if you decide to book with us). |
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| Chair Type: | Ballroom:__________ Folding:_________ | ||
| Quantity: | _____________ | ||
| Color: | White:_______ Black:_______ Ivory:______ | ||
| Sash Color: | _______________ | ||
| Type | Boxed Elegance ______ Pressed For Time ______ Cinderella ______ Chairished Events ______ | ||
| Company Name: ( If any ) ____________________________________________________________ | |||
| Customer Name: | First: ____________________________ Last_____________________________________ | ||
| Address: ( Billing address on card) _______________________________________________________ | |||
| City: | _________________________ | State/Province: | _______ Zip Code:_________ |
| Phone#: | _________________________ | Cell Number#: | ___________________________________ |
| Fax: | _________________________ | Email: | ___________________________________ |
| Credit Card #: | _________________________ | Type: | ___________________________________ |
| Expiration Date: | _________________________ | Authorization #: Located on back of card - 3 digit # |
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| Corporate Card: _______________ Personal Card _______________ | |||
| Charge my account 1/2 the balance: _____ Charge my account to be paid in full: _____ I authorize Chairish the Occasion and/or Chairished Events to charge my credit card for an amount equal to any orders place by my authorized agent(s) or myself. Should Chairish the Occasion and/or Chairished Events agree to accept my company or personal check, I agree to allow my credit card to be charged for any bounced check(s) plus a $35.00 returned check fee and any and all bank fees incurred as a result of my returned check. The undersigned individually warrants and guarantees payment of the above account. As consideration for extending credit, we promise to pay based on terms extended. In the event that the account becomes past due, incurs late, damaged, missing or shipping fee’s, I understand that these fees wiill/may be charged to my credit card. I agree that the rate of $50% of my order per day will be added for late fees until paid in full. In the event payment is not made on or before the due date, and the account is placed in the hands of a collection agency, attorney or court of law, or suit of the same is collected through probate or bankruptcy proceedings, then an additional reasonable amount shall be added to the same as attorney or court fees. I also agree that I will not dispute any charges for the merchandise that I or my agent(s) have requested. Signed: __________________________________________________Date: ______________________ |
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| PLEASE NOTE: THIS FORM MUST BE COMPLETED AND RETURNED REGARDLESS OF HOW YOU CHOOSE TO PAY FOR YOUR RENTAL ORDER. YOUR RESERVATION MAY BE CANCELLED WITHOUT NOTICE IF THIS FORMED IS NOT RETURNED ALONG WITH YOUR RENTAL CONTRACT. | |||