Fax or Mail Order Form
(please print):

Contents:

• Section 1: Bill-To Information
• Section 2: Payment Information
• Section 3: Ship-To & Order Information
• Section 4: Comments

Section 1 - Bill-to Information

Mr.____ / Mrs.____/ Ms. ____

First Name:________________Last Name: ________________________________

Address1:____________________________________________________________

Address2:____________________________________________________________

City:______________________State/Province:____________ Zip:____________

Country: _________________________ Email: ______________________________

Phone: ___________________________ Fax: _______________________________

Section 2 - Payment Information

Payment Method: Mastercard ___/ VISA ___/ AMEX___/ Discover____/ Paypal _____
Check or Money Order ___/
Note: If pre-paying by check, send payment to Art Watches, PO BOX 1585 Glendora, CA 91740 USA.

Credit Card #: _______________________________ Expiration: ____________

Name on Card: _______________________________________________________

Please sign:____________________________________________________________

Section 3 - Ship-to & Order Information

Please send the following order:
Is the Ship-to address the same as the Bill-to address? Yes___ / No___
(If yes, leave this section blank.)

Mr.____ / Mrs.____/ Ms. ____

First Name:________________Last Name: _________________________________

Address1:____________________________________________________________

Address2:____________________________________________________________

City:______________________State/Province:______________ Zip:___________

Country: _________________________ Email: _____________________________

Phone: ___________________________ Fax: ______________________________

Comments:__________________________________________________________

Section 4 - Comments

Please enter any special instructions here. If you would like a gift card included at no charge with your order, please enter the Gift Message here.

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

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Thank you for ordering from Art Watches!