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McCarty Pottery
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FAX OR PHONE ORDER WORKSHEET

If you would prefer to fax in an order, or call in your order, this form can help facilitate your request. This form is not an online entry form. You will need to right click your mouse, and then click your print option. Depending on your printer settings, the worksheet might not print perfectly, but still can prove a useful. This form is simply a tool to gather your information correctly. The final total that you fill in most cases will not be your final bill. We will fax, or email you the the final invoice, and will require that you authorize the charges, by faxing us or emailing us back your confirmation.

OUR FAX NUMBER 601-366-1475

OUR EMAIL COMMISSARYORDERS@AOL.COM

OUR VOICE LINE 888-366-1849

MONDAY - FRIDAY 8 AM 3 PM CST

Account Preferences: Add my information to the internet store? Yes No (circle)

Online Newsletter: Yes No (circle)

Shipping Method: Ground 3 Day 2nd Day Overnight (circle)

Residential or Commercial Delivery (circle)

Email Address ________________________________________

Billing Address: (Where credit card bill is mailed)

Customer Phone Number_________________________

Customer Name__________________________________________

Address________________________________________________

City________________________________________________

State_______ Zip_____________

Company Name_________________________________________

Company Phone Number_________________________

Fax Number_______________________________

Shipping Information: (Write SAME if information provided above)

Phone Number_____________________________

Name__________________________________________

Address________________________________________

City______________ State______ Zip _____________

Payment Type:

Visa Master Card American Express Discover (circle)

Name on Card_________________________________________

Card Number__________________________________ Exp_________

Signature________________________________________________

Item #

Description

Qty

Price

Extension

5300208

My First Purse

2

$ 10.38

$ 20.76

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Subtotal

Shipping

Total

Mississippi Destinations add 7% Sales Tax

Sales Tax .07

$___________

$___________

Grand Total

$___________

THIS WORKSHEET IS NOT A FINAL TOTAL. IT IS ONLY FOR INFORMATION PURPOSES ONLY.

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AGE / PRICE / TYPE Of MERCHANDISE / BRAND NAME / SEE ENTIRE STORE / TOP SELLERS

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