E. M. Foley Gift
Shoppe
360 Scott Street Wilkes-Barre, PA
18702 570 823 6490
or
787 Wyoming Ave. Kingston, PA 18704 570 714 6383
Order Form
(Use
this as a guide for information needed)
Email Orders ( open 24/7)---
evelyn@emfoleygifts.com
Print the order form (you may
have to copy and paste)
Fill in information email to above email address or
Call us at 1-570-823-6490
Ask for Evelyn, Debbie or Mike
Customer Name: Date: |
Ship to Address:
(must have a street name for UPS delivery, unless UPS approves and delivers to your RR address.) |
City:
State: Zip Code: Country: |
Telephone: Email: Fax: |
Payment selection: Mastercard Visa Discover American Express or Money Order |
Credit Card
#:
Expiration
Date:
If you are concerned about security, send
in two different e-mail messages |
Name as it appears on Credit Card: |
Code on reverse side: |
Item | Description | Price | Quantity | Total |
- | - | - | - | $ |
- | - | - | - | $ |
- | - | - | - | $ |
- | - | - | - | $ |
- | - | - | - | $ |
- | - | - | - | $ |
- | - | - | - | $ |
Product Total | $ | |||
ADD S/H charges | $ | |||
. | Grand Total | $ |