My Vintage Hut Order Form

Please send in your order to

My Vintage Hut,

c/o: Cynthia Miller,

P.O. Box 2474,

Riverside, CA 92516

USA

** Make Payable To: Cynthia Miller **

Please fill in the billing name and address exactly as it appears on your credit card statement. Inaccurate information could result order delay. After your order is received, you will get a personal confirmation email with details. Or if you want me to call you, just write a note.

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Quantity	Description	Price

Billing Name
Card Type	VISA MasterCard Check/Money Order Gift Certificate
Card Number
Exp Date
Phone Number with Area Code
Billing Address
Billing Address Line 2
Billing City
Billing State/Province
Billing Postal/Zip Code
Billing Country
Email Address
Enter Email Address Again

More information:
How did you hear about us?
Magazine
Referral
Showroom
Web
If web link, what site?