Name (First, Last)

Company Name

Shipping Address:

Order (See Example Below this Form)

Qty - item name- scent choice - package choice

Check the Following that Applies:

Please add Shipping Insurance.
No Shipping Insurance, I will risk it.
Delivery, will meet half way w/$5 fee
Delivery Full way under 1 hour w/$10 fee

I Understand and Agree to:

Will be billed via PayPal Invoice for Order
Separate billing for Shipping via PayPal Inv.
DVG is not liable for damages by Carrier
I have the option for shipping Insurance

Comments/Instruction