| [Janet Weil Prints] | If you're looking for something special, email us. |  |
Please print this form and mail it to: Weil
Antique Prints and Maps, 401 Sutters Mill Rd. St. Peters, MO
63376-2553
USA phone: 636-939-4970 e-mail: cweil@weilprints.com
This will establish a customer account for you and allows you to
order prints without sending payment information
across the Internet, unless you wish to do so. Please See our
“CONDITIONS OF SALE” for procedures.
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Customer's Mailing & Shipping Address: (UPS requires a
street address)
Name: __________________________________________________________________________
Address: ______________________________________________________ Apt#______________
________________________________________________________________________________
City: __________________________________ State: _________ Zip:
___________-___________
Country ________________________________
| Daytime Phone Number: | Evening: | |
| When is the best time to call? | ||
| E-mail Address: Mandatory on foreign requests: | ||
| PRICE | ||
Items being ordered: ____________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
SUBTOTAL __________________________________________________________________
MO SALES TAX: If ordering from MO@7.225% ___________________________________
Packing, shipping, Insurance (minimum $8.00 for 1st print)Call or E-mail for exact amount: ________________
Total: (in U. S. Funds) __________________________________________________________
Credit Card Information: Please use only MasterCard_______ or Visa_______
| Card Number ____________________________ | Expiration______/_____ |
Signature (Required on credit card orders) : ________________________________________
Request: have us send you information about:
_____________________________________________________________________________
_____________________________________________________________________________
| [Janet Weil Prints] | If you're looking for something special, email us. | |