Wholesale Order Form

Wholesale Order Form

Download Printable Order Form
Buy One Share One….Awareness Bugz Are Packaged Individually In A Trendy Clear Chinese Take Out Container. Minimum Order Is 30 Units Of One Style. Price Per 30 Units Including Bugz Donation $112.50, ($ 3.75 Each Suggested Retail Price Is $6.99)

Date: _______________________________________________________

Name: _______________________________________________________

Address: ____________________________________________________

City: _____________________ State: __________ Zip: __________

Telephone__________________Fax________________Cell___________

Tax ID # ________________________Tax Exempt #________________

Awareness Bugz are sold 30 minimum per style, $112.50 per 30.

Credit card only for Awareness Bugz

HIV Awareness Butterfly: Qty: ________ Total: $______________

Breast Cancer Awareness: Qty: ________ Total: $______________

Troop Support Awareness: Qty: ________ Total: $______________

Domestic Violence Aware: Qty: ________ Total: $______________

Total: $__________________

Shipping and Handling to be added

We accept * Mastercard* Visa * American Express *

Card Number: ________________________________________________

Exp Date: ______________3 digit code__________________

Name of cardholder: _________________________________________

Address of cardholder: _____________________________________

City: _______________________ State: ________ Zip: __________

Shipping address if different from above:

Address: ____________________________________________________

City: _______________________ State: ________ Zip: __________

I authorize the above transaction: __________________________


PLEASE FAX YOUR ORDER TO: toll free 1 866 269 6290

Credit card will not be charged until the order is ready for shipment. Please allow ten days for receipt of order. SHIPPING AND HANDLING CHARGES WILL BE ADDED.

ORDER WILL BE SENT FED EX GROUND. RUSH ORDERS $10.00 ADDITIONAL CHARGE PER ORDER.



For questions concerning your order please email orders@bugz.com or call our office at 860 283 2254

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