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CatNip Boutique

Layaway Program Agreement

First & Last Name:
Your Email Address:
Telephone No:
Billing Address:
City, State, Zip:
Country
Designer & Style No:
Size & Color:
Wear Date:
Credit Card No:
Experation Date (MM/YYYY):
CVC Code (3 digit code in the back of CC):
Payment Plan (check one):	25% Down 1Payment
	25% Down 2Payment
	25% Down 3Payment
	25% Down 4Payment
	50% Down 1Payment
	50% Down 2Payment
	50% Down 3Payment
	50% Down 4Payment
Message:
I Accept all terms and conditions	Yes email form
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Signature - By checking the box above to accept terms and conditions your are also taking action equivalent to signing the credit card receipt for the payment of goods