Please print this order form and fill it out. Please fax your order to Our American Heritage at (610) 695-0980 - Fax Available 24 hrs - 7 days

            Your billing information:

First Name

    

Last Name

 

Street Address

  

City

  

State:

Zip Code:

Day Time Phone #

 

Evening Phone #

 

E-mail Address 

 

For FedEx tracking information purpose only.  Please provide your correct email address. Confirmation will be sent to you

Credit Card

Visa   Master     American Express

Cardholder Name

 

Card Number

 

Expiration Date

 

CCV Number*

  Required

Your Signature

 

* CCV Number - On the reverse side of Visa and MasterCard's on the Signature line to the right, a 3 digit number after the last 4 numbers of your account #

   For American Express Cards - A 4 digit number located in the lower right corner on the face of the card or a 3 digit number as above for Visa/MC

          Your ordering information: Need More Room ?  Please just use a second blank page to write additional items

ITEM QTY AMOUNT
     
     
     
     
     
TOTAL    

          Your shipping address if it is different from your billing address:  Sorry NO PO Boxes - Must ship to Street Addresses ONLY

First Name  
Last Name  
Company  
Street Address  
City   State
Receiptant Phone   Zip
Gift ?   Gift Box ?  Card ?   Gift Bag ? 
Message   

Thank you for your order. 

If you have any questions, please feel free to call us at (866) 884-3299.  Thank you for shopping at Our American Heritage Stores Copyright 2007