Creations Unlimited Home Creations Unlimited 4 Emery Drive Whitehouse Station, NJ 08889       (908) 534-4924 To order by mail, please print this form, fill it out and mail it to the address above. Billing Information (Please note that we can only ship to addresses in the USA.) Name __________________________________________________ Street __________________________________________________ __________________________________________________ City _________________________________________State_________ZIP ____________ Telephone (_______) ______________-__________________________ email __________________________________________________ (For contact purposes in case there is a question on your order, to provide order confirmation, and to provide you with shipping confirmation.) Payment Type [ ] American Express           [ ] Master Card           [ ] Visa           [ ] Discover           [ ] Personal Check Card # __________________________________________________ Expiration _____________________3 or 4 digit Security code_________ (from the front of American Express or the back of other cards) Shipping Information (You can leave this blank if it is the same as your Billing Address) Name __________________________________________________ Street __________________________________________________ __________________________________________________ City _________________________________________State_________ZIP ____________ Order Information (If you prefer, you can use the on-line shopping cart, view the cart, and then print that form and attach it to this sheet, instead of copying all of the information.) Item # Item Name How many Price each Total Shipping SAMPLE Halifax sailing ship, 5x7 with 8x10 mat 2 $9.00 $18.00 $2.00                                                                         Total merchandise   NJ, NY, and PA residents add sales tax   Total shipping   Total order   Note: We will adjust the sales tax or correct arithmetic errors, if necessary. * Your privacy is important! Creations Unlimited does not intentionally supply any mailing list information to any third party. We are not in the business of selling names or addresses. Any information supplied by you will be used in the strictest of confidence. Creations Unlimited will not participate in "Spamming" on the internet. We only send mail to those people who have expressed an interest in receiving our mailings.