Important Note: We can only accept MasterCard and Visa credit cards
on foreign orders.
Sorry, no checks, bank drafts or money orders.
| HEARTLAND HOUSE DESIGNS MAIL ORDER FORM | ||||||
|---|---|---|---|---|---|---|
| ITEM NO. | ITEM NAME | KIT PRICE | KIT QTY | CHART PRICE | CHART QTY | TOTAL |
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MERCHANDISE TOTAL |
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Illinois residents add 8% Sales Tax |
. | |||||
POSTAGE & HANDLING in USD ( US $3.00; CANADA $4.00; ALL OTHER COUNTRIES $6.00) |
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TOTAL AMOUNT DUE |
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| Name | ||||||
| Address | ||||||
| City State Zip | ||||||
| Phone Fax | ||||||
| Check/MO Credit Card No. (Visa, MC) Exp. Date | ||||||