Fiddlesticks Gifts Online Order Form (http://www.fiddlesticksgifts.com)

On-Line Order Form

For MULTIPLE SHIPPING ADDRESSES:
Please fax your order to 731-286-4400
Please print this page for handy reference while browsing our pages.

[FrontPage Save Results Component]

First Name Last Name

Street Address

Address (cont.)

City State Zip Code

Work Phone

(xxx-xxx-xxxx)
FAX

(xxx-xxx-xxxx)
Home Phone

(xxx-xxx-xxxx)

E-mail

Please provide the following ordering information:

QTY
DESCRIPTION
Price

BILLING

Credit Card

Cardholder Name

Card Number
(xxxxxxxxxxxxxxxx no dashes)

Expiration Date (mm/yy)

SHIPPING

Ship to Name

Street Address

Address (cont.)

City

State Zip Code

Ship to Phone
(xxx-xxx-xxxx)

Gift wrap available- please specify- Man, Woman, Child, Baby Boy or Girl, or Wedding
in the comments field following your order information below:

Please provide any additional information here.

prices do not include shipping.

In order to better calculate the total cost of your order,
Please refer to the shipping charge chart.

Order On-line

to Fiddlesticks Gifts

Copyright © 1999 Fiddlesticks Gifts
Website Maintained by: MEC Designs.

First Name		Last Name
Street Address
Address (cont.)
City		State		Zip Code
Work Phone	(xxx-xxx-xxxx)	FAX	(xxx-xxx-xxxx)	Home Phone	(xxx-xxx-xxxx)
E-mail

	BILLING
Credit Card
Cardholder Name
Card Number	(xxxxxxxxxxxxxxxx no dashes)
Expiration Date	(mm/yy)

	SHIPPING
Ship to Name
Street Address
Address (cont.)
City
State		Zip Code
Ship to Phone	(xxx-xxx-xxxx)