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ONLINE

ORDER

FORM

 

INFO ON THE ITEM YOU WANT

(Required)

Which Co-op member is your product made by?

What type of product is the item?

Enter the product ID for the item you want or the pattern number:

Enter the quantity of the item you wish to purchase:

Please type any additional comments on the item you may have:

DESTINATION TO SHIP TO

(Required)

Recipient's Name:

Street Address: P.O. BOX:

City Name: ZIP CODE:

State/Province: Country:

Is this a gift?:

Should purchaser be kept anonymous?:

If you can have a brief message sent with the item what would it be?:

PURCHASER INFORMATION

Purchaser's Name:

Street Address: P.O. BOX:

City Name: ZIP CODE:

State/Province: Country:

EMAIL ADDRESS (required):

DAY TIME PHONE (required): NIGHT PHONE:

PAYMENT INFORMATION and MORE

CREDIT CARD INFORMATION (only if paying by credit card):

Credit card type:

Credit Card Number: Expiration Date (mm/yyyy):

OTHER PAYMENT METHODS:

Which method of payment do you wish to use? (required):

HOW WOULD YOU LIKE THIS SHIPPED? (required):

Do you want the shipment insured? (required)

Please type any additional comments here:

 

 

IF YOU'RE DONE THIS IS WHERE TO GO

 

 

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