Ordering Page-Woodstock Original Fence Pendants

Order Form

Please fill out this form to order peace pendants. You can either send the form to us via the Internet, fax the completed form to us at: 845.482.3040, or mail payment to address on the bottom of this page.

First Name:
Last Name:
E-Mail Address
Shipping Address:
Shipping Address 2
City:
State:
Zip:
Phone:
Credit Card Billing Address if different:
City:
State:
Zip:
Payment Information:
Debit:	Credit:
Master Card:	Discover:	Visa:
PayPal: If using PayPal, please send payment to: Clalexy@yahoo.com		Money Order, Check, or Cash:

Credit Card #:
Expiration Date:		(Ex - 06/2003)
V-Code:		( 3 Digit code on back of most cards)

Pendants are $39.95 each plus $4.95 shipping and handling in the USA per order. International shipping is $12.95 per order.
	How many peace pendant necklaces do you want?:
	How many peace pendant key rings do you want?:
	How many cross pendant necklaces do you want?: (shown in photo on main page)
	How many cross pendant key rings do you want?:

Additional Comments:

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If you wish to mail order pendants, please
send payment to:

Alexy Ultrasonics Corp.
PO Box 70
Bethel, NY 12720 USA

josephalexy@yahoo.com
(845) 482-3000 fax: (845) 482-3040

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