Ordering Form

Ordering Information
*On Phone: Print Form, Fill, & Send

Name Address    City, State Zip Country
Phone Number E-mail (optional) FAX (optional) P.O. Number (optional)

[] Use Alternate Delivery Address (work address, etc - where post office delivers)
Name Address    City, State Zip Country

Payment Information    -    please print carefully
Note Method of Payment
[] Check or Money Order (Payable to Li'l Britches)
[] Cash
[] Credit Card: MasterCard, Visa, or Discover
Card #:
Card Verification #:
Expiration Date:

Product Information use product tables at bottom of page to fill out
Circle One Breed Measurement (inches)How to Measure Weight (pounds)How to Weigh Pattern *Pick Fabric
Female Dog Diaper
Male Dog Diaper
Male Belly Band
Quantity Size Price Product Total
$ $

Tax (7% for Indiana Residents) $                 
Choose Shipping
$
Total Enclosed $

Copyright 2015, Li'l Britches

Click to print this information

Li'l Britches - Order Form
225 W.Maumee Street, Angola IN, USA 46703 USA
www.lilbritches.com — phone: (260)243-0155
E-mail: