Order Form

There are several way you can place your orders. 1. Online shopping cart, using Master Card or Visa Card (all credit card orders are taken over a secured line). Please see our Privacy Policy.   2. Phone, mail, email (csm@moweryantiques.com).Our shopping cart does NOT charge your card when you check out, we do that here in our office once we have your order invoiced and ready to ship

Shipping Address:

Name:
Street:
City:
State/Prov. Zip/Postal Code:  
Country: Telephone Number:
Fax Number: E-Mail Address:    

Billing Address: (If different than shipping address)

Name:
Street: 
City: State/Prov:       
Zip/Postal Code: Country:           


Credit Card Information:

Credit Card Type:

 
Name on Credit Card:
Credit Card Number:
Credit Card Expire date (MM/YY)


Products Ordering
:

Item #

Description

Quantity

Price

Total

         
         
         
         
         

   Sub Total:

  Shipping & Handling (See Below):

Tax: PA Residents add 6% (PA Sales Tax)

Grand Total:

Shipping Charges
(for Continental U.S. only)

$0.00 to $50.00

$8.00

$51.00 to $100.00

$10.00

$101.00 to $150.00

$14.00

$151.00 to $200.00

$16.00

Orders over $200.00 will be quoted in conformation.  
All orders will be insured

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