A Very Special Collection
PRINT AND MAIL FORM

Print out order blank, complete form, and mail to:

A Very Special Collection
PO Box 2243
Yorktown, VA 23692

Fax or phone in completed order to: 757-867-7711


Name: Date:
Address: Phone:
City & State: Zip:

Item# Name Quantity Item Price Extension

Shipping & handling:

$ .01 to $6.00 - $1.50
$6.01 to $12.00 - add $3.00
$12.01 to $36.00 - add $7.15
$36.01 to $60.00 - add $8.00
...... over $60.01 - add $13.45

Make checks payable to:
A Very Special Collection

For credit card payment:
Circle One:
Visa --- Master Card --- Discover

Account Number:


Expiration Date:


Security Code:

Signature:

 

         
         
         
         
         
         
  Sub Total  

Virginia residents add 6% sales tax.

Sales Tax  
See chart to determine correct shipping
Shipping  
  Total Due  

All International Orders
Please do not place international orders thru this web site.
It is set up for shipping US orders only.
Send international orders via e-mail for shipping rate.

THANK YOU!


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© Copyright 2014 A Very Special Collection, P.O. Box 2243, Yorktown, VA 23692. All rights reserved.