The Toy Soldier Gallery Fax Form
Fax: (845) 446-1050 • Toll Free: 1-800-777-9904 • Tel: (845) 446-6731

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Date _______________________________________ Phone #: _________________________

Name: _______________________________________________________________________

Address: _____________________________________________________________________

City: ____________________________State:_____________________ Zip: ______________
ORDER FORM
QTY
CAT #
 Description
PRICE
SUBTOTAL
         
         
         
         
         
         
         
         
         
         
         
         
         
         
Mastercard / Visa / American Express / Discover

Card #_____________________________________

Expiration Date:_____________________________

Signature:__________________________________
Subtotal
Shipping at cost
8.125 % NYS Sales Tax
Total

 
 
 
 
WE ACCEPT:
VISA, MASTERCARD, AMERICAN EXPRESS AND DISCOVER