Please fax or mail this form to us. If you are paying by check, please
email us to let us know that you
are sending payment by check.
Thank you for ordering from Things Gone By!
Our address is:
Things Gone By
PO Box 325
Reedsville, WV 26547 USA
Phone: (001) 304 864 5921 Fax number is: (001) 412 202 1694
______ (initial here please) I have read and agree to the Things Gone By policy regarding Returns and Other Important Information
* indicates a mandatory field.
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Your Name |
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DESCRIPTION of item (s) you are ordering: |
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Reference number(s): |
Name of Item and price: |
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| Payment Type (please select one) | |
| ___ Check (Please email) or ___ Credit Card (Visa/MC only) | |
| Layaway | |
| __ I am sending a Layaway Contract for these items. |
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| Credit Card Information | |
| Type of Credit card | ___ Visa or ___ Mastercard |
| Cardholder Name _______________________________________________ |
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| Card Number _______________________________________________ |
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| Expiration Date (mm/yyyy) _______/_________
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| Billing Address-MUST BE EXACT credit card billing address | |
| *Street address | ________________________________
________________________________ |
| *City | ________________________________ |
| *State/Province | ________________________________ |
| *Zip/Postal code | ________________ |
| Country | ________________________________ |
| *Phone | ________________________________ |
| Fax | ________________________________ |
| ________________________________ |
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| Shipping Address If you are paying by credit card, We CANNOT ship to any address other than the credit card billing address. We apologize for any inconvenience this may cause you but it is for your protection. If you pay by check, we can ship to any address. |
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| ___ I am paying by credit card and know that the item will be shipped to my billing
address
___ I am paying by check so please ship to the following
address: |
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| *Street Address
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________________________________
________________________________ |
| *City | ________________________________ |
| *State/Province | ________________________________ |
| *Zip/Postal code | ________________ |
| Country | ________________________________ |
| *Phone | ________________________________ |
| Fax | ________________________________ |
| ________________________________ |
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Shipping charges are not included in the price of the item. Buyer pays shipping charges via insured, priority US Mail. Note: If you do not receive confirmation of your order within 24 hours, please email me.