Scottish Heritage USA Order Form
		SEND ORDER TO:
		Scottish Heritage USA
		PO Box 457
		Pinehurst, NC  28370
		Phone: (910) 295-4448
		Fax: (910) 295-3147
		Email:  shusa@embarqmail.com
		Please print this Order Form, fill out, and send/fax to above address, please include all pages.
		QTY		ITEM		PRICE		TOTAL
				BALL CAP (with tartan visor)		$22.00/ea		$
				TENNIS VISOR		$18.00/ea		$
				BOWTIE (pre-tied with adjustable neckband)		$26.00/ea		$
				NECKTIE (57" with 4" blade)		$33.00/ea		$
				NECKTIE (Special Order) (62" with 4" blade)		$35.00/ea		$
				MINI-SASH (36" x 5" with 6" Rosette)		$32.00/ea		$
				GOLF CAP (satin lined with stretch headband)		$57.00/ea		$
				SCARF (11" x 59" with 1.5" fringe and hemmed)		$49.00/ea		$
				LADY'S SASH (11" x 89" with 5" fringe and hemmed)		$69.00/ea		$
				STOLE (69" x 17" with 5" fringe and hemmed)		$89.00/ea		$
				FABRIC BY THE YARD (100% worsted wool)		$80.00/yd		$
				(fabric is priced per yard)
		SPECIAL ORDERS
				LADY'S TAM (satin lined with stretch headband)		$38.00/ea		$
				CUMBERBUND		$53.00/ea		$
				TOTAL				$
				Shipping Charges (from list on Page 2)				$
				ORDER TOTAL				$
		SHIPPING AND HANDLING WILL BE AN EXTRA CHARGE
		Please add charges to order as listed in Shipping Charge Chart below
		CHARGE		ORDER TOTALS
		$5.98		$1.00 to $20.00
		$6.98		$20.01 to $35.00
		$8.98		$35.01 to $45.00
		$10.98		$45.01 to $55.00
		$12.98		$55.01 to $70.00
		$14.98		$70.01 to $85.00
		$16.98		$85.01 to $100.00
		$18.98		$100.01 to $120.00
		$19.98		$120.01 to $150.00
		$21.98		$150.01 and over
		CUSTOMER ORDER INFORMAITON
		BILLING ADDRESS:
		FIRST NAME: _____________________   LAST NAME: _____________________________
		ADDRESS 1 _______________________________________________________________
		ADDRESS 2 _______________________________________________________________
		CITY ______________________________    STATE ________________   ZIP ___________
		PHONE NUMBER:  __________________________
		EMAIL ADDRESS:  _________________________________________________________
		SHIPPING ADDRESS
		Check here if same as billing address
		FIRST NAME: _____________________   LAST NAME: _____________________________
		ADDRESS 1 _______________________________________________________________
		ADDRESS 2 _______________________________________________________________
		CITY ______________________________    STATE ________________   ZIP ___________
		PAYMENT TYPE
		[   ] Credit Card     [   ] Check     [   ] Money Order
		PLEASE MAKE CHECKS OR MONERY ORDERS PAYABLE TO:  Scottish Heritage USA
		CREDIT CARD INFORMATION
		We accept:
		Card Type:  [    ] VISA     [    ] Mastercard
		First Name ________________________  (as it appears on card)
		Last Name ________________________  (as it appears on card)
		Card Number: _________________________
		Expiration Dated: ________________  (mm/yy)
		Security Code ___________  (3 digit number listed on back of card)
		Payment Amount: ________________________
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