FORM

Please fill out form & fax form back to: (800) 346-3514

Customer Information

Name: Street:
City: State: Zip:
Phone: Fax:
E mail Address:
Credit Card#: Exp.
or phone your order in (928) 778-2291
Mail to: Western Icons, HC30 Box 932M • Prescott, Arizona 86305 USA


Icon Name: Qty: Total:
Icon Name: Qty: Total:
Icon Name: Qty: Total:
Total:


Terms

All sales are prepaid in full prior to shipping. Cash, money order, or cashiers check.
Credit cards accepted: American Express.
Sorry no C.O.D.'s. Please allow 2-4 weeks for delivery.

We ship Federal Express all classes of service.

Western Icons will Fax or Email an order confirmation back to you with your total including shipping charges.




©1999 Western Icons, All Rights Reserved