<p> lia sophia Order Form – Bracelet Sale Vickie Bermea, Independent Advisor  (408) 832-3498  www.liasophia.com/VickieB  [email protected] Date: Hostess:</p><p>Page# Style # Size Item Name Price Total Full Price (least expensive) Full Price (least expensive) 1/2 Price (most expensive) 1/2 Price BRACELET 1/2 Price BRACELET 1/2 Price BRACELET Full Price (least expensive) Full Price (least expensive) 1/2 Price (most expensive) 1/2 Price BRACELET 1/2 Price BRACELET 1/2 Price BRACELET Total Jewelry Purchase Shipping/Insurance $3.80 Tax: ( Add Total & Shipping/Ins. together at 8.25%) Total Due</p><p>Customer Name ○ Visa ○ Master Card ○ Discover</p><p>Phone</p><p>Email credit card number</p><p>Address Exp. Date amount City ______State Zip Signature Please provide address and phone number. as it appears on statement. Would you be interested in ... ○ Learning more about the lia sophia opportunity?  Yes  No  Maybe ○ Having your own girls night out & earning free jewelry?  Yes  No  Maybe ○ Receiving updates on specials and events via a monthly○ Visa e-newsletter? ○ Master  Card Yes  ○ NoDiscover  Maybe ○ If your hostess was starting her own lia sophia, business would you be willing help her out and host a party for her in the next 30 days?  Yes  No  Maybe credit card number</p><p>Exp. Date ______Signature amount</p>