& www.twcwatches.com
Last Update: September 28, 2004 Fax Order Form
Fill out this page, print it out and fax us your order to us at (304) 260-9079
Item # Qty Description Price
Description
Name Phone FAX E-mail
Payment by: Check Money Order VISA MasterCard American Express Cardholder name Card number Exp Date Shipping ( Need credit card billing address if different ) Street address Address (cont.) City State/Province Zip/Postal code Country
Any other comments for your order (color, size, shipping instructions, etc.) ?
Table for Shipping Charges (please inquire if you have special shipping instuctions)
$9.00
$5.00
$15.00
$24.95
$30.00
$21.50
Miles Pocket Watches & TWC watches 233 Tasley Ct. Martinsburg, WV 25401 E-mail: mileswatch@aol.com
Stephen Miles, Proprietor NAWCC Member #0139087 Phone: (304) 260-9078 Fax: (304) 260-9079 Toll Free: 1 (888) 739-0124