ORDER HOURS
Monday through Saturday! 10:30 am - 5:00 pm Pacific Time
To place an order (personal service) call
with your credit card: Call 1-(541)264-5908
For immediate shipping!		 Print out this form, fill in and send by:
FAX Your Order T0: (541) 265-8260
Or Mail Orders To:
                         FACETS
                         PO Box 714
                         Newport, OR 97365
Please Print CLEARLY ALL OF THE FOLLOWING:                       Date:
Billing Address:
First Name:_________________Last:_______
Address:______________________________
______________________________________
Daytime phone (for any questions)_________________
E Mail_________________________________		 Ship To: Mail receptacle _____Yes_____No
Commercial Business_____Yes_____No
Business:_____________________
Recipient:____________________
Address:_______________________
___________________________________
Phone:________________________
We will choose method of delivery unless you specify one below.
USPS Media Mail ( )  USPS: Priority ( )  UPS Ground ( )  Other_______________
Note: Please provide  a street address  for any delivery other than U.S. Postal Service.
Quantity
Item and shipping weight                                         Unit Price
 Extension
                
$        .      
  
   
 
  
    
 
  
   
 
  
   
 
  
        
 
  
       
  
  

Policy: Shipping & handling will vary depending on weight and destination. Please call us at (541) 264-5908 and we will calculate your freight charges as undercalculated freight charges will delay your order. Report any shipping  damage to the carrier immediately!

Sub Total
 $          .
  
$          .
Call 1-(541) 264-5908 for Shipping & handling rates
 $          .
Order Total
 $          .
     Select Your Method Of Payment   (Check One Below) NO COD'S + NO Purchase ORDERS accepted!
    _____Check or Money Order enclosed (made payable to Facets).
PLEASE NOTE: (Shipment will be held up to 14 days waiting for check to clear.)
    _____VISA   _______Master Card  _______Discovercard
    Credit/DebitCard Number __ __  __ __    __ __  __ __  __ __ __ __  __ __ __ __
    Expiration Date:  Month __ __   Year __  __ C.C.V.# (Last 3 numbers from the back of the credit card):  __ __ __.
    PRINT  Name as shown on card:______________________________________________

I authorize this transaction and the resultant charges to my Credit/Debit Card Account as provided above and acknowledge and affirm that I am the authorized credit card holder. I promise to pay the above amount in accordance with the terms and agreement of my bank or other financial institution that issued the credit card.
Signature________________________________________________Date__________
Thank you very much for your order.
Copyright © 2016   Agates of the Oregon Coast a division of FACETS    All rights reserved.