Belvoirdale order form:


FirstName: 

 LastName: 

  Company: 

   E-mail:  (your existing address)

  Address: 

  Address: 

     City:   State:  Zip: 

      Tel: 

      Fax: 




Payment Methods
Credit Card Pre-Payment by Cash or Check I'll Call in, Thanks

If you'd like to prepay with check or money order please send to:

Belvoirdale
PO Box 176
Wyncote, PA 19095

If you want to call --> (215) 886-7211
or Fax --> (215) 886-1804

Credit Card: (if applicable)


MC Visa Amex None

Credit Card #: Expiration Date:

Name of Cardholder:
Orders:

Quantity: Description: $:
Quantity: Description: $:
Quantity: Description: $:
Quantity: Description: $:
Quantity: Description: $:
Quantity: Description: $: 
           Subtotal:  

 PA Res. Add 6% Tax:  

Shipping & Handling:  

          TOTAL DUE:
Shipping and Handling Rates (Continental US only)

Subtotal Priority Mail
Up to $30 or 2 lbs $6.00
$31-$60 or up to 4 lbs $8.75
$61-$100 $12.75
Over $100 as incurred

Shipping outside U.S.A as incurred by Belvoirdale. 


Referrals

How did you find us?  Who Referred you?: 






 Any comments? Questions?




Main Page



Send E-mail To: President Grahame Maisey