Country Calendar
E-Mail --Order Form for Hats Only
We take (all) Major Credit Cards -----U.S. Funds Only
Ship by - (UPS Or Post Office) --Just fill in the white area

You can print out a copy of this form and mail it or fax in

Date of Order

Name

Last name first

UPS Address

Apt #

If no apt, put no

City

State

Country

Zip

Phone

Fax

E-mail

-
Hats 1
Hats 2
Hats 3
Name of Hat

Style

Hat color

Brim size

Option codes

Size

Cost

Notes

METHOD OF PAYMENT:

CHECK CK# Credit Card

CREDIT CARD TYPE

EX. DATE

CREDIT CARD NUMBER

CID CODE ON THE BACK OF THE CARD --LAST 3 NUMBER WITHIN THE SIGNATURE PANEL

SIGNATURE AS ON CARD

Subtotal

CA sales tax x .0825

Shipping Cost

Check here

Total

We pay all shipping costs within the US & Canada

All Other see Shipping Cost

Minimum order is $10.00

This is not a secured server, you might want to call in your Credit Card number or fax it in.

Phone US & Canada 1-800-427-8101 or other 925-935-5995

Fax 925-939-9312
Mail

Country Calendar - - -P O Box 3178 - - - Walnut Creek, CA. 94598