Museum Shop Order Form

Museum Shop Order Form
Louisa May Alcott’s Orchard House - Home of Little Women
Attn: Mail Order, P.O. Box 343, Concord, MA 01742-0343
Shop Fax: 978.369.9611 • Phone 978.369.4118 x 107

Customer Information: (please print)
Name:
Street Address:
City/State/Zip:
Daytime Phone:	Email:

Would you like email updates? Yes No
Have you ordered from us before? Yes No If no, how did you hear about us?
Ship To: (if different from above address)
Name:
Address:
City/State/Zip:

Method of Payment:

Check (payable to "Orchard House") Check #
MasterCard Visa American Express

Card Number: Expiration Date:

Credit Card Verification Number: Click to see examples

Full name on credit card:

Order Information:
Quantity	Item	Size/Color	Price

Regular Postage and Handling
NOTE: Additional postage may apply to heavier items like books and mugs.
$0.01 - $14.99 = $5.95 $15.00 - $24.99 = $6.95 $25.00 - $39.99 = $7.95 $40.00 - $59.99 = $8.95	$60.00 - $74.99 = $9.95 $75.00 - $99.99 = $10.95 $100 & above = $15.00 per $100
Special Postage and Handling
"Scrabble" $8.95 shipping for 1st "Scrabble" ordered; $2.00 for each additional Little Women Alexander Dolls Shipping: $12.00 each Additional shipping for Louisa May Alcott Alexander doll; please call 978.369.4118 for details.
Add 50% for Canadian and double the amount for overseas orders

Merchandise Total
Member Discount (10% for members)
Mass. Sales Tax (Residents only, add 5%)
Postage and Handling
TOTAL
*Thank you!*

Special Notes:

Please print this form and fax or mail to Orchard House.
Or click here for a single-page form in pdf (Adobe Acrobat) format.

Office use only:
Initials: _______
Date recd. ________
Date filled: _________
Mail __ Fax __ Phone__