Please Send Order Form To: Customer Assistance Center Allen Edmonds Corporation PO Box 998 201 East Seven Hills Road Port Washington, Wisconsin 53074 ship to: Name: address: city:
state:
zip:
Daytime phone:
evening phone: Please notify me of future sales and special offers via email.
email: Please send me the following order: style Name
style no.
Apparel size
shoe size
shoe width
Qty.
description
unit price
total
order form
page
method of payment check
charge to:
visa
Merchandise Total mastercard
american express
discover gift card
Subtotal MN and WI Residents ONLY add all applicable sales tax
card number: expiration date:
Express Shipping Charges
security code*:
TOTAL $ cardholder signature: To view our PRIVACY POLICY regarding your payment information, please visit AllenEdmonds.com. *Security code for MasterCard, Visa and Discover can be located in the signature area on the back of the card and is three digits in length. Amex cards have a four digit number which is printed on the front of the card.
bill to: (If different than “Ship to� Address above) Name: address: city:
state:
Daytime phone:
evening phone:
email:
zip:
Please notify me of future sales and special offers via email.
Available at Allen Edmonds retail stores, AllenEdmonds.com or through our customer assistance center. If you have questions or to order by phone, please contact our Customer Assistance Center at 1-800-235-2348 or cacmail@AllenEdmonds.com. Customer Assistance Center Hours: 7am-6pm CDT, Weekdays. Sizes and styles vary by location. Free shipping & returns on all domestic US ground orders.
Free Domestic Ground Shipping & Returns at AllenEdmonds.com
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