All fields noted with an ( * ) must be filled in.

Name:*		We accept American Express, Visa, Mastercard, Discover and Pay Pal. If you have a Pay Pal account simply go to www.PayPal.com and send funds for the amount of your order to our email address: orders@mazaltovpages.com
Company:
Address:*
City:*
State:*
Zip Code:*
Country:* (Required for outside of U.S.)
Tel:*
Bus. Tel:
Fax:
E-mail:*
Credit Card:*	Please Check One:   (If not paying by check) Visa Master Card Amex  Discover
Credit Card #:*
Exp. Date:*
C/C Security Code#:*	*Please type in the last three digits of your credit card verification security code # located in the back of your (Visa, Master Card, or Discover) credit/debit card, in the provided box below: (Amex accounts; please type in the last four digits above your credit account # on your card):
Online Signature:*	By typing your name in the "Online Signature" below, and clicking the "Submit Form" button on bottom of this form, you hereby agree to the Terms and Conditions of MazalTovPages.com Merchant Policy and hereby authorize the credit card payment for the merchandise ordered.
How did you     hear about us?	Please Check: Friend/Business E-mail Radio Flyer/Mail Ad Search Engine Other, please specify in box below
Name:  E-mail:	If you checked the box above for a friend, please provide us with his/her name and e-mail so that we can send a thank you.

**Do you want your purchase beautifully gift wrapped at $6.00 per item?

Order Information

Quantity	Item No.	Description	Color	Price @	Total
				Merchandise Total
			S&H	Shipping & Handling (Please see the chart below)
			FL Residents	Add 6% Sales Tax
				Total

*If you find the table above complicated, you don't want to fill it out or have additonal merchandise and/or information to add, you are welcome to e-mail us your order. (**Make sure to provide us with your name, billing & shipping address, telephone/fax #'s, the item(s) that you want to purchase, qty, cat. #, desciption, i.e.: size, color, price, personalization text - if applicable, as well as any special instructions that you may have, and then we will call you to obtain your credit card information, if you will not include it in our secure e-mail system).

Shipping & Handling Table

If this is a gift, please check one of the following:

 Wedding   Anniversary     Bar / Bat Mitzvah      Special Occasion    
New Baby    New Home    Holiday     Other

Please ship this purchase to (fill out only if ship to address is different than bill to):

Name:
Address 1:
Address 2:
City:
State:
Zip:
Country:* (Outside of U.S.)
Tel:
Bus. Tel:

*If you find the form above complicated or you don't want to fill it out, you are welcome to e-mail us your order. (**Make sure to provide us with your name, billing & shipping address, telephone/fax #'s, the item(s) that you want to purchase, qty, cat. #, desciption, i.e.: size, color, price, personalization text - if applicable, as well as any special instructions that you may have, and then we will call you to obtain your credit card information, if you will not include it in our secure e-mail system).

*No returns on printed, personalized, customized or special order items.

**Our minimum purchase order is $25.00 (before the S&H charge).

Full payment required with your order.

*If we are unclear on any specifics of your order, we will contact you. Otherwise, we will promptly begin working on your order.

Thank you for using our service!