Mail Order Form

Please note that all prices are in US$, and Pennsylvania residents must add 6% sales tax. The rates for shipping and handling are shown at the bottom of this form, following the area where you may enter your product selection. All Replitiques items are made-to-order, and we will typically ship within 6-8 weeks after receipt of your order. We will call or e-mail you to confirm receipt of your order and to provide an estimated ship date at that time. Once we have shipped your material, we will also let you know your order is on its way.

Reminder: This form must be printed and then mailed to us. If you want to place your order securely on-line, simply click on the HOME link above, then click on a product on the left-side of the "HOME" page. You can send us your order on-line by going to a product page and selecting the "Add to Cart" icon. When asked about payment options during the order process, you may then choose "pay by check", which means you'll send the order electronically, and follow-up by mailing a check.

This form is for you to use if you don't want to do anything electronically; you may print this form and mail it to: Replitiques, 120 Orchard Ave., York Haven, PA 17370

Please provide your name, shipping address (including apt. or suite number, if needed), city, state, and zipcode.

Other address information to help us contact us you case of any questions about your order:

Phone:
Email:

Fax:

Payment:

Please charge my Visa    Mastercard

Credit card number:

Card expires on:

Check Enclosed: $

Please list the items you'd like to purchase, along with your chosen color, the quantity of each item, and its price.

Subtotal $:

PA Tax(6%):

Shipping&Handling:

Please visit our shipping information page to figure out what your shipping charges will be.

Final Total:

Other Information: