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
To order via email, please write to scody@louisamayalcott.org
DO NOT INCLUDE CREDIT CARD INFO IN EMAIL!

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 Discover Diner's Club

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 - $ 9.99 = $4.95 $10.00 - $24.99 = $6.95 $25.00 - $39.99 = $8.95 $40.00 - $59.99 = $10.95	$60.00 - $74.99 = $12.95 $80.00 - $99.99 = $14.95 $100.00 - $124.99 = $16.95 $125.00 - $149.99 = $18.95 Over $150.00 = $19.95
Special Postage and Handling
"Scrabble" $8.95 shipping for 1st "Scrabble" ordered; $2.00 for each additional
Add 50% for Canadian and double the amount for overseas orders

Merchandise Total
Member Discount (10% for members)
Mass. Sales Tax (Residents only, add 6.25%)
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__