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CIGAR BAND FORM

Boy   Girl   Man   Woman   Business  Event   Other
 Qty.

Prices

Name

Date of Birth or Event

Time of Birth or Event     AM      PM

Weight (birth orders)

Length (birth orders)

City & State of Birth, Birthday or Event

Other Info

Yellow Highlight area is for Credit Card Billing Info:
Please be complete and accurate on all sections of the form.
Thank You!

Master Card   Visa   Discover   Amex   Number--- Expires
Name as it appears on card and approval to charge card for this order
V-Code (click here to find it)
Credit Card Billing Address
No. & Street
City, State Zip
Phone in Card number if you prefer Toll Free (877) 685-6397

Ship To:

Orders for Birth are printed EVERY DAY! Mon. thru Fri.
*guaranteed next day with Fed X.
*Orders received by 12 noon PST ship the same day. (FedX guarantee guidelines apply)

Or use Priority Mail by the US Postal Service, usually 2 to 4 days for delivery.
There is a $3. handling fee on all orders.

CHOOSE ONE    Priority Mail       FED X
Choose this box for FedEx to leave without signature
Choose this box for Saturday Delivery
Prices
Orders placed on Friday by noon can be delivered Saturday with FedX.
Your order will arrive Monday if Saturday delivery is not checked.


Phone Number (home) Phone Number (work)
E Mail address

Additional comments:

Where did you hear about us? or How did you find us?

THANK YOU FOR YOUR ORDER!

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