Print out this form and fax to: 617-387-7894

IMPORTANT: When Ordering:  Page __________ OF __________
1.. Please supply all information requested, especially recipient's zip code and phone number.
2. Please verify all delivery address data.
3.. No P.O. boxes please. Street addresses or rural route numbers only.
4.. Order by gift name and Item number.
5. Please type or print clearly.

Step 1. Billing Information

Name__________________________________________________________________________

Company_______________________________________________________________________

Address:________________________________________________________________________

City_________________________________State:_________________Zip:___________________

Day Phone_________________________ Evening Phone_________________________________

Email Address___________________________________________________________________

Step 2. Indicate Your payment Preference
Charge to:
VISA
MasterCard
Discover
American Express

Credit Card Holder Name:___________________________________

Credit Card Number:_______________________________________

Expiration Date:___________________________________________

Credit Card Signature:______________________________________

Promotion Code:__________________________________________

Step 3. Itemize Gift Purchases

Item No.	Item Description	Qty	Price	Shipping	Total Price
Subtotal
Shipping (please see shipping options)
Total Amount

Step 4. Indicate Your Delivery Preference
As soon as possible.  Delivery Week _____________________________________

Step 5. Fill in Gift Recipient Information - (Print as many Gift Recipient pages as needed)

Recipient's Name:
Company Name:
Phone No.:
Street:	Apt.No.:	Floor:
City:	State:	Zip:
1st Choice:	Item No.:	Qty:
2st Choice:	Item No.:	Qty:
Shipping Method: Ground ($12.50) Two Day Guaranteed ($25.45) Overnight Express ($37.95) Deliver the week of:__________
Card Greeting & Signature:

Recipient's Name:
Company Name:
Phone No.:
Street:	Apt.No.:	Floor:
City:	State:	Zip:
1st Choice:	Item No.:	Qty:
2st Choice:	Item No.:	Qty:
Shipping Method: Ground ($12.50) Two Day Guaranteed ($25.45) Overnight Express ($37.95) Deliver the week of:__________
Card Greeting & Signature: