Coastal Vacations Purchase Order Form
   Date


 

                                                            Ship to: 

Eric and Eileen Brigantino
340 Broad St.,
St. Emmaus, Pa 18049
Toll Free: 877-796 4749

 

Name:

Address:

City:

State:

ZIP:

Phone:

E-Mail:

   

PACKAGE

PRICE

QUANTITY

TOTAL

Level 1: The Coastal Vacation Package

 

$1,295 x

 

 

SUB-TOTAL:

FREIGHT:
{FED EX 2nd day air $25)

BALANCE DUE:

 Credit card orders will be phone verified before processing. There is a 10 day money back guarantee.  Package and all materials must be returned in clean, unused re-sellable condition. No exceptions.