chickendance.gif (16781 bytes)

AUCTION PAYMENT - SECURE ONLINE ORDER FORM


A prompt will appear, and
You will be asked to accept the secure page.
Click yes and proceed!

**PAYING WITH **

DISCOVER.GIF (1839 bytes)

Please Fill out the form COMPLETELY
with ALL your Information & choices & punch Send!

IF YOU WOULD LIKE ADDITIONAL ITEMS - BESURE TO TELL ME! YOUR Email Address is REQUIRED!!!
You will receive a email from Me 
Confirming that the Information was received!
Your card will not be charged until items are shipped!

If you are concerned about listing your credit card info - 
Please - Fill out the form with all information but the number
Send The Form ... and
Call me with your number!
(315) 597-5330
or Fax me: (315) 597-6892

Metrodate.com - The Ultimate Singles Resource Metrodate.com - The Ultimate Singles Resource

AUCTION - Purchase Order Form
Email*:
NAME:
Address:
CITY:
STATE:
ZIP:
PHONE / CELL:
AUCTION SITE:
AUCTION NUMBER:
ITEM NAME 1 & NUMBER:
PRICE:
I WOULD LIKE ANOTHER ONE:



Which Item?:
ITEM WIN 2 NAME & NUMBER:
PRICE 2:
ITEM WIN 3 NAME & NUMBER:
PRICE 3:
PAYMENT VIA CREDIT CARD - VISA, MC, DISCOVER:
EXPIRATION DATE:
3 DIGIT CVC # ON CARD BACK:
PAYING VIA PAYPAL:
INVOICE MY PAYPAL - MY PAYPAL EMAIL IS:
I AM SENDING POSTAL MONEY ORDER - addressed to NURSERY, PO 252, PALMYRA, NY 14522:
SHIPPING - adjusted to quantity:
TOTAL:
COMMENTS:

Powered By Pliner.Net
Pliner.Net is not responsible for the content of member forms.

WE ALWAYS HAVE EXTRA IN STOCK!

FIRST SETS ARE WIN BID PRICE, EACH ADDITIONAL SET PRICE IS $9.99.

SHIPPING AND HANDLING FOR EXTRAS VARIES ON DESTINATION.

1 SET SHIPPINGS $7.99

2-3 SETS FOR $9.99

4-6 SETS FOR $13.99

Go to our Home Page?