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Telluride Gifts
Order Form
 
   
  Order Form  
     
 
Zia Sun
PO Box 4170 | 214 W. Colorado Ave | Telluride, CO 81435
970.728.4031 | 970.728.1201 (fax)
info@ziasungifts.com

This form is secure should you choose to email it.
Your name:
Billing Address:
Shipping Name and Address
(if different):
Telephone:
Email:
   
Credit Card Information  
Name as it appears on the card:
Credit Card Type(Visa, MC, Amex):
Credit Card Number:
Expiration Date:
Signature Panel Number
(3 digit number at end of signature panel):
   

Item Description QTY Price Extension
   
#1001 Main Street Glass Ornament
  Small
  Large
  Votive
   
#1002 Bridal Veil and Mt. Wilson
  Small
  Large
  Votive
   
#1100 Main Street Ceramic Ornament
   
#1500

The Telluride Puzzle
   
Shipping Charges
Please enter the appropriate shipping:
Up to $35.00 - $8.95
$35.01 to $75 - $10.95
75.01 to $100.00 -  $12.95
$100.01.01 to $150.00 - $15.95
$150.01 to $250.00 - $18.95
$250.01 to $350.00 - $19.95
$350.01 and Over - 7% of Total
Additional charges for service other than UPS Ground.
Please call for details.
   
Total Amount  

If a gift, please check here and indicate to whom you wish it sent in the shipping address. We will send your credit card receipt to the billing address listed above.  

Please print, sign and fax OR hit submit email this form to us. We will send your gifts to you via UPS (no PO boxes, please).

Signature:

Zia Sun
PO Box 4170 | 214 W. Colorado Ave | Telluride, CO 81435
970.728.4031 | 970.728.1201 (fax)
info@ziasungifts.com