ORDER FORM
P.O. BOX 889
10714 County Road 245
NEW CASTLE, COLORADO 81647 - USA
INQUIRES:
FAX:
ORDERS ONLY:		 (970) 984-3685
(970) 984-3266
1-800-473-8709
PAYMENT: Wintercount accepts both Visa and MasterCard
You may phone your order on our toll free number or include your card number and expiration date in the credit card information area of the order form. Payment is required with all orders. A refund will be included with the order if an item is out of stock. (Include a backup choice if you have one.) NO COD’S ON RETAIL ORDERS

Please Note: All Name and Address Fields are REQUIRED, so please make sure you fill every box in or it will come back as an Error.

After we receive your request we will confirm your order with a return e-mail.
Thank you!!

Don't worry, if you make a mistake you can hit the "RESET" button and start over again.


Name:(First and Last)
E-Mail Address:
Billing Address:
Shipping Address:
Daytime Telephone:
Evening Telephone:




Add Shipping Costs According To Chart: These charges do not apply to framed pieces
Up to $30.00
$3.95
$30.01 to $50
$4.95
$50.01 to $100
$6.95
$100.01 to $200
$9.50
$200.01 or more
Add 3.5% to Total

What products would you like to order?
Please fill out Item Number with the quantity you wish to purchase.

Ordering Information:

Product Number:



  		 Code:
C=card P=print
I=Inspirational

 Quantity:



 Price Each:



$ 		Sub Total:



$
$ $
$ $
$ $
 
Shipping Charges:
$
 
Grand Total:
$

Credit Card Information: This is A Secure Form!
MasterCard or Visa? MasterCard Visa
Name as it appears on Card:
Account Number:
Expiration Date:

Any Comments or Suggestions:


Thank you for your Order!