Elevated Energy, Inc.
Crystaltopia: Purchase Form
How many items are being purchased?
Please enter the inventory #s here.
Type of payment
Credit or Debit Card
Total amount received for this order
including 9.5% sales tax?
Items will have to be added up manually, sorry.
Does the customer want a receipt?
Please create a manual receipt to give them, then submit this form. Disregard the next page.
Please submit this form and disregard the next page.
Please enter the exact amount to be charged to the credit or debit card on the next page. If the customer wants a receipt, please enter their name and email address on the next page.
Do Not Fill This Out