MIME-Version: 1.0 Content-Location: file:///C:/CC74CAAD/HDG_OrdeForm.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" HEARTS DESIRE GIFTS Order Form - Print this form and Mail or FAX to 972-386-6006

HEARTS DESIRE GIFTS Order Form - Print this form and Mail or FAX to  817-275-1080

(You must call us before faxing so we can turn on our fax machin= e)

Item Number

 NAME of Item / Description

Quantity

PRICE

 

Billing Information=

 

Credit card

 

Cardholder Name  

 

Card number

 

Expiration date

   MONTH YEAR

 

Billing Address

 

Address (Cont'd)

 

City and State

 

Zip/Postal Code

 

Phone Number

 

E-Mail Address

 

 

 

Shipping Information (if differ= ent from above)

Name

Street = address

Address (Cont'd)

City an= d State

Zip/Pos= tal Code

We will confim your order by e-mail within 24 - 48 hours

EMAIL US HERE