Different Directions 
Order Form

There are 2 ways you may order 

1) Fill out all information listed on page and click on the submit button below. 

2) Print out this page.  Please Note: 1 or 2 pages will print out depending on your Web browser, print settings, and printer. You may need to adjust your print settings accordingly. If your printer splits this form, simply fill in the needed fields and send all pages to Different Directions. 

Completely fill out all lines on the order form. If you would like to send the product as a gift, please include the recipient's name, address and phone number in the additional comments block or if ordering by mail attach it on a separate sheet with this form and we will include a gift card on your behalf. 

Mail completed order form and payment to Different Directions, P.O. Box 318, Lodi, WI 53555 

or
Fax this form to Different Directions (608) 592-5970 

You can also order by phone simply by calling Different Directions at (608) 592-2059 

 
Your Name 
Product
Price
Address 
City 
State 
Zip 
Country 
Phone 
Method of Payment: 
Check /Money Order
Mastercard /Visa /Discover

(please double check method of payment)
*Shipping 
  
*Sub Total 
  
Card # 
Exp. Date 
*Sales Tax 
Signature
TOTAL 
(Signature is only required on charge card purchases if mailed) 
Additional Comments or Instructions
E-Mail Address: 
Free Black Satin Gift Pouch included with each product.

*Sales Tax Note:  Wisconsin residents please add 5.5% sales tax. 
*Shipping Note:   For Domestic (USA) shipments  please include $2.95 shipping charges for up to 5   items, 
                                 over 5 items add 50 cents per item. 
                         For International shipments please contact Different Directions. 

Allow 7 to 10 days for delivery. All products fully guaranteed.
 
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