Legacy 925 Order Form

Please print clearly & be sure to include any special instructions.
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Legacy 925
Tel: (970) 387-4004, Fax: (970) 387-4005
Email
 

SHIP TO NAME

 

Ship To Address

 

City, State, Zip Code

 

Telephone  (Day & Eve)

 

Email Address

 

BILL TO NAME

 

Bill to Address

 

City, State, Zip

 

Telephone  (Day & Eve)

 

Email Address

 

Circle One:    Visa -or- MC

 

Expiration Date

 

Signature on Card

 

How did you hear about Legacy 925? (magazine, friend, web link, search engine, etc.)

 

Item Number & Name/Description

Size

Color

Qty

Price

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Special Instructions:

 

 

 

 

 

 

 

 

 

 

 

Add Organza Gift Pouch (click here for choices)

 

 

 

$3.00

 

Gift Occasion/Gender:

 

 

 

Subtotal:

 

Click here for Shipping Rates

 

 

 

Shipping:

 

Colorado residents add 7.9% sales tax.

 

 

 

Sales Tax:

 

THANK YOU FOR YOUR ORDER!

 

 

 

TOTAL:

 

GIFT CARD MESSAGE: