1. Please Print Out, Fill Out and Fax Your Order to (607) 724-6422
OR
2. Please Print Out, Fill Out & Snail Mail to Address Listed at the Bottom of this Page
**PLEASE PRINT SHIP TO INFORMATION BELOW**
Date:
First and Last Name:
Street and Apt. No.:
City, State, Zip Code:
Email:
(Area Code) Telephone: Please Indicate Day/Night
** For Individual Bead Listings, Do NOT Fill In Price Per Each **
** Only One Price of $21.95 Per Bracelet Will Be Charged **
Quantity
Item No.
Description
Price Each
Total
Subtotal
NYS Tax 8%
Shipping
TOTAL
Payment and Shipping
Payment Method: (Please Check One)
Visa:_______ MasterCard:_______ Check:_______ Money Order:_______
Orders paid for by Check will not be shipped until the check has cleared at the Bank.
Card Number:_____________________________ Signature Code:__________
The Signature Code is a new security feature found on the back of most Visa and MasterCard credit cards. This three-digit value helps to ensure that the customer has a legitimate credit card in his/her possession. The code is located immediately following the credit card account number.
Card Holder Name:_______________________________________
(Please Print - Credit Card Billing Address Must be Same as Shipped To, If Not, an Email will be sent for verification (This is for Consumer Fraud Protection and Safety)
$5.99 Flat Rate Shipping and Handling Fee - Continental United States. Your order may be shipped United States Postal Service (UPSP) Priority Mail or Ground Service, for all orders within the continental United States, unless otherwise noted by White Buffalo Beads and Stones because of shipping area and / or otherwise specified by Customer.
$9.60 Flat Rate Shipping and Handling Fee - Shipments to Alaska, Hawaii, Puerto Rice or the US Virgin Islands via USPS Priority Mail.
Special Shipping Instructions:______________________________________
All international orders, including Canada, is a flat rate fee of $15.99. Additional charges may be incurred due to weight of package.
Duties and Taxes
Our pricing does not include duties, insurance costs or value-added taxes. If assessed, these charges are the responsibility of the package recipient, who will be billed for them by the local Customs office.