Gift - Order Form - Antique Watches

FAX-ORDER FORM
2272 Colorado Blvd., #1216, Los Angeles, CA 90041, USA
If you do not have a fax machine and prefer to use our online Secure Order Form please click here.

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E-mail: goodwatch@hotmail.com
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Please print this form, fill it out and fax it to us. Please print clearly.

IMPORTANT: PLEASE INCLUDE PHONE NUMBERS.

Name: Phone: (day)

(evg)

Fax: E-Mail:

Address: City: State: Zip:
Country:

I am ordering: (Page, Make, Ref#, Price):

To process credit card orders, we also need the following information:

Date: Name as on Card:

Billing address:

Type:( Visa/MC etc. ): Number:

Expiration Date: Signature:

Total Amount of Purchase: $ I agree to pay this amount in accordance
("Total" - below; ) with my Credit Card Agreement.

Please allow 2 - 3 working days for shipment.

Watch Total: $

    Shipping:       $              (see below for rates)
    Insurance:     $
    Subtotal:       $

+2.5% $ ( To be added if not paying by Check, Money Order or Bank Transfer )

Total: $________
Please enclose check or money order.
( To pay by wire transfer, please call. )

Notes:
See below for shipping inside the U.S.A., please inquire for other destinations. We charge 3% if you are not paying by Check, Money Order or Bank Transfer. Please allow 2-3 business days for shipment. Delivery times may vary when shipping to cities outside the continental US. All shipments are insured for full value, and include a watch box.

Shipping charges:
Express - 1-2 days: $19.00 (includes $100 insurance. Add $1 per $100 over $100)
Priority - 2-3 days: $6.00 (plus $1 per $100 for insurance)

All overseas orders are shipped Express mail. - Basic rates to some countries are slightly higher. Please inquire.

THANK YOU FOR YOUR ORDER !