Order Form - White Pavilion Clothiers - Renaissance - Medieval

Order Form To complete the order form print, then mail to White Pavilion, P.O. Box 8842, Gallatin TN, 37066 or fax to 615-230-5776. Please view our Size Chart and Shipping and Ordering pages for helpful information. We ship UPS as a rule.*
Ship to:			Payment:
Name:			Check ( ) Money Order ( )
Street/Box:			Credit Card
City/State:			MC ( ) Visa ( ) Discover ( )
Zip:			Card#:
Phone:			Expiration:
Email:			Signature:

Item#	Item Name		Size	Color	Quantity	Total










Shipping Rates up to $50 = $4 $51 to $100 = $6 $101 t0 $150 = $8 $151 to $200 = $9 Over $200 call for quote		Special Instructions			Handling:	$4.00
					Shipping:
					Total:

*If you prefer the U.S. Postal Service, or must have delivery to a P.O. box, be aware that the U.S.P.S. does not guarantee delivery or track stray parcels on any but express (overnight) service. Therefore, we cannot be responsible for parcels lost by the U.S.P.S. unless they have been sent via Express Mail.