Ordered By (Billing name and address) Shipping Address
Name:
Street:
City:State:Zip:
Name:
Street:
City:State:Zip:
Telephone (optional, but it may help us expedite your order).
Day (      )Evening: (      )
A. Gift Recipient Shipping Address
Name:
Street:
City:State:Zip:
Telephone:
Gift Message:
 B. Gift Recipient Shipping Address
Name:
Street:
City:State:Zip:
Telephone:
Gift Message:
Method of Payment (no cash or two-party checks please)
[ ] Check or money order (US Funds only)
[ ] MasterCard
[ ] Visa
[ ] American Express
Card #:Exp. Date:
Print cardholder's name:
Cardholder's signature:
(required for charge orders)
List Merchandise Please print clearly. Thank You.
Item # Quantity Description Size Color Unit Price Ship To
Circle for delivery to gift recipient		 Total
gloves and mittens
             A    B   
             A    B   
             A    B   
             A    B   
             A    B   
             A    B   
             A    B   
             A    B   
Shipping and Handling Charges Within the United States
If your merchandise totalsAdd
Up to $50$5.50
$51 to $100$7.50
$101 to $200$9.50
$201 to $300$12.50
Over $300$15.00
 You can order through our web site 24 hours a day! The latest encryption technology ensures that your order is secure. As with telephone orders, products are shipped via UPS ground delivery.
Merchandise total  
Shipping/handling  
Express delivery  
For items delivered to NY State, please add appropriate sales tax. (on shipping and handling too)  
Grand Total  

Thank You for your order.
Please remember to enclose your check or credit card information.

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gloves and mittens

Adirondack Region
1420 Curry Road
Schenectady, New York 12306
(518) 355-1630
Fax (518) 355-1631
Email Newberry Knitting