Customer Mail Order Form - Print & Mail or Fax
Ship to:  (Enter Billing Address below if different)
  Name:_________________________________________________
  Address:_______________________________________________
  City/State/Zip:__________________________________________
  Email Address (optional):__________________________________
Billing Address:  (Billing Address for Credit Card orders only)
  Name:_________________________________________________
  Address:_______________________________________________
  City/State/Zip:__________________________________________
  Phone Number (optional): (_____)_____-_________
  Email Address (optional):__________________________________
Mail Orders to:
  Virtual Gift World
  P.O. Box 452
  Mastic Beach NY 11951
  www.virtual-gift-world.com
  virtualgiftworld@aol.com
  Fax # 631-395-4594

Date:_____/_____/____
Item # Product Description Attributes Quantity Price Each Total
      
      
      
      
      
      
      
      
      
 Merchandise Total
Sales Tax (NY only)
Shipping (see Shipping Chart below)
Coupon Code (if any)                              
Gift Certificate Key (if any)                                
Amount Due
 
 +
 +
 -
 -
 

Shipping Chart
Order AmountShipping Charge
Under $34.99$7.95
$35.00 to $44.99$8.95
$45.00 to $54.99$9.95
$55.00 to $74.99$11.95
$75.00 & Higher$12.95
This covers normal ground shipping within the continental US. All orders are shipped out within 48 hours.

Payment Information
Check #______________________
Money Order 
Certified Check
(Make checks payable to "Virtual Gift World")
Credit Card
    Master Card     Visa
    Discover          America Express

    Card Number:_____________________________

    Expiration Date: ___/____/_____

    Signature: _______________________________