EAGLE GIFTS GALORE
2707 S. DESERT FOREST AVE., ONTARIO, CA 91761   Voice:  (909) 947-6634
Fax: (909) 947-6666     e-Mail:  EagleGiftsGalore@gmail.com      http://www.EagleGiftsGalore.net

RESIN  EAGLE  PLATE  PLAQUE ORDER  FORM

Fill in this form print it, 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.


I am in the process of updating this website and Order Form.
Most of the resin Plate Plaque prices have increased,
and there are a couple new styles available.
ALL of the Shipping and Handling prices have increased.
Please call for current prices and availability.



ENGRAVING  INFORMATION
(Maximum 30 spaces per line)
Line # 1     Date plate is needed by:
Line # 2     - -

ORDER   SUMMARY
Plaque Type:            
California Sales Tax*       @   7.75%           =  
Shiping & Handling     @   $   16.75       =      $  16.75
        Total                                       =   
* California Residents only



Billing Address
  Name          
 Address 1    
 Address 2    
 City              
 State                      Zip      
 E-Mail    
    Main Phone Number
   Home       Mobile  
    - -
  Second Phone Number
   Mobile       Work  
    - -

Shipping Address (if different)
We must have a phone number for the shipping address.
  Name          
 Address 1    
 Address 2    
 City              
 State                      Zip      
    Phone Number
    - -

PAYMENT   INFORMATION:
     Check Enclosed      Credit Card      PayPal    
Send PayPal payments to EagleGiftsGalore@gmail.com
 
CREDIT  CARD   INFORMATION:
Name on Credit Card:
First Name Middle Initial Last 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: ________________________________________________________________________________

Rev. 03-2018