Montgolfier Balloon Gift Shop Order Form

INSTRUCTIONS: Print out this Order Form. Fill in your complete name, mailing address and daytime phone number in the provided space. Please print legibly! Enter your choices to the form. Add totals for all items, plus tax (CA only) and shipping (see chart). Please, checks or money orders only in US dollars on a US bank. Personal checks need to clear before shipment. No wire transfers or foreign currency. Make checks payable to Alpha Promotions & send to:

NAME:

ADDRESS:

CITY:

STATE: ZIP:

DAYTIME PHONE: ( )

eMAIL:

Montgolfier Balloon Gift Shop

15055 Cerezo Road
Victorville, CA 92392

e-mail: alphapromo@dslextreme.com

Orders must be paid in full. Items subject to availability. Prices subject to change without notice.

ITEM NUMBER	MONTGOLFIER BALLOON GIFT SHOP	QTY	PRICE	TOTAL
***********	UNIQUE JEWELRY	**	********	********








************	BROOCHES AND PINS	**	********	********








************	UNIQUE GIFTS	**	********	********

SHIPPING and HANDLING CHARGES
If Price Between:	Add	If Price Between:	Add
$1.00 - 15.95	$8.60	$16.00 - 25.95	$11.60
$26.00 - 35.95:	$12.60	$36.00 - 50.00:	$13.60
Over $50.00	$14.60	Price includes Handling Charges

SUBTOTAL

TAX
(CA Residents only add 7.75%)

SHIPPING (see chart at left)

ORDER TOTAL