Wild Visions, Inc. Order Form

BILLING ADDRESS:                       SHIP TO: (IF DIFFERENT FROM BILLING)

Name ________________________________ | Name ________________________________
                                      |
Address _____________________________ | Address _____________________________
                                      |
Address _____________________________ | Address _____________________________
                                      |
City ________________________________ | City ________________________________
                                      |
State ____________  ZIP______________ | State ____________  ZIP______________
                                      |
Country _____________________________ | Country _____________________________
                                      |
Daytime Telephone (_____) ___________ | Daytime Telephone (_____) ___________
                                      

 Quantity  Item#               Description                Price     Total   
|-------|--------|--------------------------------------|---------|---------|
|       |        |                                      |         |         |
|-------|--------|--------------------------------------|---------|---------|
|       |        |                                      |         |         |
|-------|--------|--------------------------------------|---------|---------|
|       |        |                                      |         |         |
|-------|--------|--------------------------------------|---------|---------|
|       |        |                                      |         |         |
|-------|--------|--------------------------------------|---------|---------|
|       |        |                                      |         |         |
|-------|--------|--------------------------------------|---------|---------|
                                                Merchandise Total |         |
                                                                  |---------|
            Shipping/Handling (per US or Canada shipping address) |    $7.50|
                                                                  |---------|
                                                        Sub Total |         |
                                                                  |---------|
            NY Sales Tax on orders shipped to a NY State address  |         |
                                                                  |---------|
                                                      Grand Total |         |
                                                                  |---------|

    NY State Only Sales Tax-  |                        |       |      |
    County being shipped to:  |________________________| Tax % |_____%|

 
MasterCard, VISA, Discover |        |        |        |        |
American Express           |________|________|________|________|

                  |        |
Expiration Date   |________|   Signature  __________________________________ 

           Please Make Checks Payable to: Wild Visions, Inc.
                                 Send to: 6990 State Route 8
                                          Brant Lake, NY  12815-2229
Office Use Only - Shipped __________ Approval # ______________ Date__________

PLACING YOUR ORDER
    1. Call (518) 494-3072 to order by credit card, or for questions (Mon / Fri from 9 AM to 5 PM Eastern Time).
    2. Or, FAX this form to (518) 494-3072, or mail this order form with credit card information, or a check or money order (US Funds) to:
                     Wild Visions, Inc.
                     6990 State Route 8
                     Brant Lake, NY  12815-2229

DELIVERY
We ship most items via Priority Mail. If you prefer to have an item 
shipped by another method please contact us for more information. Please 
remember to add shipping and handling for each shipping address (if more than one).
OUR GUARANTEE
If any item you order doesn't meet your expectations, it may be returned 
within 15 days for an exchange or refund.
(Please note: shipping and handling charges are not refundable.)

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