EAGLE   GIFTS   GALORE
2707 S. DESERT FOREST AVE., ONTARIO, CA 91761   Voice: (909) 947-6634
Fax: (909) 947-6666     e-Mail:  egg@EagleGiftsGalore.net     http://www.EagleGiftsGalore.net
CERAMIC  WB  PATROL  ANIMAL   BEADS  ORDER  FORM

Fill in and print this form, sign it, and Fax or mail it to the address above.
Please do NOT send Credit Card information via eMail.
All prices subject to change.



ANIMAL QUANTITY ANIMAL QUANTITY
   
   
Beads . . . . . . . $ 2.25 each.
Shipping & Handling:   1 - 3 Beads
  4 - 10 Beads
  11 + Beads		  $   2.50
 $   3.75
 $   6.00
California Residents add 8.75% Sales Tax.  Orders of 1-10 Beads will ship First Class.
Orders of 11 or more Beads will ship Priority Mail.

ORDER   SUMMARY
 
Total # of Beads     @     $   2.25   =  $   
Calif. Sales Tax *   @     8.75%   =  $   
Shiping & Handling   @   $    =  $   
Total Order   =  $ 
* California Residents only


Billing Address
 Name      Home Phone     - -
 Address 1      City    
 Address 2      State      Zip    
 E-Mail      Cell/Wk Phone     - -


Shipping Address (if different)
  Name       Phone     - -
 Address 1      City    
 Address 2      State      Zip    






EAGLE   GIFTS   GALORE
2707 S. DESERT FOREST AVE., ONTARIO, CA 91761   Voice: (909) 947-6634
Fax: (909) 947-6666     e-Mail:  egg@EagleGiftsGalore.net     http://www.EagleGiftsGalore.net
CERAMIC  WB  PATROL  ANIMAL   BEADS  ORDER  FORM  PAGE   2


PAYMENT   INFORMATION:
 Check Enclosed
  Please charge my Credit Card
CREDIT  CARD   INFORMATION:
Name on Credit Card:
First NameMiddle NameLast Name
Please make sure that the Billing Address (above) is where the credit card statement is sent.
  Credit Card Type:      Visa     Mastercard
CREDIT   CARD   NUMBER: EXPIRATION   DATE: SECURITY   CODE:
    (on back of card)
                  
 
 
Signature: ______________________________________________________________________________________