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| EquinArt Creations Inc. PRINT THIS Order Form to pay by Visa, Mastercard, American Express, personal check or money order PayPal orders MUST go through the Web site please. |
Print this order form and complete it offline. Print all information. Mail with your payment to: EquinArt Creations Inc., 1220 Hixburg Road (Rt
627), Prospect, VA 23960
Questions about your order? Call 434-574-6253 (after Oct 1 2007) FAX your order 801 - 331-1432
627), Prospect, VA 23960
Questions about your order? Call 434-574-6253 (after Oct 1 2007) FAX your order 801 - 331-1432
Your name:____________________________________Email Address (REQUIRED)___________________________
Phone number (REQUIRED) :_________________________________
Street Address:__________________________________________________________________________________
City:_________________________________________ State, Provence, Other:______________________________
Zip code (USA), Postal Code (Canada or Other):__________________________Country:_______________________
If you wish your order shipped to a different address from your home address, please write it below.
SHIP TO: ______________________________________________________________________________
Phone number (REQUIRED) :_________________________________
Street Address:__________________________________________________________________________________
City:_________________________________________ State, Provence, Other:______________________________
Zip code (USA), Postal Code (Canada or Other):__________________________Country:_______________________
If you wish your order shipped to a different address from your home address, please write it below.
SHIP TO: ______________________________________________________________________________
CREDIT CARD ORDERS. PLEASE BE EXACT. If we are off only slightly from what your
credit card company has on file (misspelled names, street address abbreviated, etc) the
processing system will not accept the credit card.
Please check:
( ) Visa ( ) Mastercard ( ) American Express ( ) Discover
( ) Credit Card ( ) Debit Card
Name as it appears on the card:_______________________________________________
Card number:_____________________________________________________________
Signature (required) _______________________________________________________
Expiration date:______________________ Three digit security code_________________
The three digit security code is on the back of your Visa or Master Card. It is the last three
numbers in the signature box. For American Express customers, the code is four digits and on
the front.
credit card company has on file (misspelled names, street address abbreviated, etc) the
processing system will not accept the credit card.
Please check:
( ) Visa ( ) Mastercard ( ) American Express ( ) Discover
( ) Credit Card ( ) Debit Card
Name as it appears on the card:_______________________________________________
Card number:_____________________________________________________________
Signature (required) _______________________________________________________
Expiration date:______________________ Three digit security code_________________
The three digit security code is on the back of your Visa or Master Card. It is the last three
numbers in the signature box. For American Express customers, the code is four digits and on
the front.
Subtotal _________________
Shipping & Handling __________________________________
VA residents
please add 5%
sales tax __________________
TOTAL ENCLOSED ___________________
Shipping & Handling __________________________________
VA residents
please add 5%
sales tax __________________
TOTAL ENCLOSED ___________________
| If you are using a gift certificate, please deduct it from the price in the order form on the "Unit Price" column. Thank you. |
| FAX 801- 331-1432 (not toll free) |
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