Online Order Form

Online Order Form

Peaches & Screams
Name

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Items:*
prevnext( X )
Rush (10 ML)$20.00

Quantity
Item subtotal:$0.00

Blue Boy (10ML)$20.00

Quantity
Item subtotal:$0.00

Jungle Juice Black (10 ML)$20.00

Quantity

Total $0.00
Shipping Address

CUSTOMER NAME. MUST PUT SOMETHING (SUCH AS VALUED CUSTOMER)

Street Address Line

CityState / Province

Postal / Zip Code
Payment Type
Orders typically take 48-72 business hours to process.

We will contact you via telephone to finalize order processing.

Phone number contacting you will be calling from 248-219-7361

Price above may not reflect savings. When payment is processed, discounts will be confirmed verbally during our call.

On your bank statement/credit card statement, transaction will show up from "SQ *PEACHES AND SCREAM MI"
- Buy 3 Promotion for $50 ($10 savings).
- Buy 2 Promotion for $35 ($5 savings).
- Free shipping on orders $75 or more.
Items sold are not for human consumption.

Must be 18 & Older to order.
Should be Empty: