Order Form

Gifts By James M. Innes

Print this form out and mail it with your payment to:

James M. Innes
P.O. Box 162124
Austin, Texas 78716-2124

Packing & Delivery via UPS (per address):

Overnight Delivery Available -- Call for Rates.

Orders outside continental USA or over $100, please phone for rates.

PAYMENT MADE BY:

GIFT ADDRESSES:

|A|

Name:
Address:
City/State/Zip:
Daytime Phone:
Payment Method __ check __money order
__ Visa __MasterCard __ American Express

Card No ________________________________

Expires ___ / ____

Signature ______________________________

|B|

Name:
Address:
City/State/Zip:
Daytime Phone:

|C|

Name:
Address:
City/State/Zip:
Daytime Phone:

Quantity	Item	Circle Preferred Shipping Address	Price Each	Total
\|	\|	A........B........C	\|	\|
\|	\|	A........B........C	\|	\|
\|	\|	A........B........C	\|	\|

	Subtotal	\|
	Packing/Delivery (each address)	\|
	Texas Residents Add Applicable Sales Tax	\|
Order Date:	TOTAL	$