Online order form

Use this form to take advantage of all sales that I'm running. To obtain any sale pricing from Pure Romance by Marci, orders must be placed using this form! Sales prices are not reflected on corporate shopping site.

Outside Pure Romance Party Order?
If you are ordering towards a Pure Romance party, make sure you type the referring hostess name on the order form.

Name *

First

Last

Street Address *

City *

State *

zip *

Email *

Phone *

Please choose one *

Web Order Party Order

Hostess name (if applicaible) *

Item 1 (name, flavor, size, scent) *

Item 2 (name, flavor, size, scent) *

Item 3 (name, flavor, size, scent) *

Item 4 (name, flavor, size, scent) *

Item 5 (name, flavor, size, scent) *

Item 6 (name, flavor, size, scent) *

Item 7 (name, flavor, size, scent) *

Item 8 (name, flavor, size, scent) *

Item 9 (name, flavor, size, scent) *

Item 10 (name, flavor, size, scent) *

Comment (Items greater then 10 enter below) *

Coupon Code (required for specials) *

Type of Credit Card *

Visa Mastercard Discover American Express

Credit Card # (XXXX-XXXX-XXXX-XXXX) *

Exp Date (MM/YY) *

CVC Code *

Billing zip code *

When hitting submit you will receive an email confirmation of your order with a final total (5.6% sales tax and $6.00 S&H will be added) within 24 hours. Your card will not be charged in real-time, but will be charged at the time of your e-mail confirmation. All orders are shipped within 7 to 10 business days. All sales are final.

Submit