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- Print out this form.
- Complete it. (please type or print).
- You can also copy it and use your text editor, remember to save in ASCII if you are
going to E-mail it.
- E-mail it to us at sales2@worldofescher.com, Fax it to us (but please call first), or snail
mail it to us at World of Escher, 1300 W. O'Neal Rd., Prescott, AZ 86305, along with your
check or money order (call for shipping amount).
- We appreciate your order, if you have any immediate questions you can call Customer
Service at 1-800-237-2232.
Billing Information:
Your Name:______________________________________________________
Address:________________________________________________________
City:___________________________________________________________
State/Province:___________________ Country:____________________
Zip/Post Code:____________________ Phone:_______________________
E-Mail Address:_____________________________________________
Credit Card Number:_________________________________________
Credit Card Type:_______________ Exp. Date:________________
Name on Card: ______________________________________________
Signature:__________________________________________________
Shipping Address: (Leave blank if same as billing address)
Recipient's Name:_______________________________________________
Address:________________________________________________________
City:___________________________________________________________
State/Province:___________________ Country:____________________
Zip/Post Code:____________________ Phone:_______________________
E-Mail Address:_____________________________________________
Requested Shipping Date:_________________
We ship via UPS standard unless you indicate otherwise:
Ship Via: Post___, FedEx___, Other___, specify ____________
Is this a gift? Yes / No
If yes, and you would like a card enclosed please indicate the
text, we use Escher postcards, random images, for your card:
_______________________________________________________________
_______________________________________________________________
YOUR ORDER
Unit
Description Size Color Qty. Price Total
--------------------------- ----- ------ ----- ------ --------
___________________________ _____ ______ _____ ______ ________
___________________________ _____ ______ _____ ______ ________
___________________________ _____ ______ _____ ______ ________
___________________________ _____ ______ _____ ______ ________
___________________________ _____ ______ _____ ______ ________
___________________________ _____ ______ _____ ______ ________
Product sub-total ________
8.3% AZ Sales tax (Arizona sales only) ________
Total order prior to shipping costs ________
Shipping and Handling (we'll calculate this) ________
Total Order: ________
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