BEYOND BASIC BEARS
1. BILLING DETAILS

First Name:____________________________________________

Last Name:____________________________________________
SHIPPING ADDRESS

Street:____________________________________________

Town/City:_________________________________________

Province/State:_____________________________________

Country:__________________________________________

Post/ Zip code:_____________________________________
CONTACT DETAILS

Home Phone No.______________________________________

Work Phone No:_______________________________________

Fax/Mobile No: ________________________________________

E-mail address:________________________________________
3. INSURANCE
I hereby confirm that all the information supplied is true and correct.


____________________________________________________
Signature (Please sign your name)





Mail this form to:
Creative Design Studio
511 Berkley
Elmhurst IL USA
60126.3725
2. PLACE YOUR ORDER
Would you like to have your parcel insured? [ YES ] [ NO ]
4. PAYMENT METHOD


[ ] Paypal/Credit Card *
[ ] Personal Cheque (US residents only) **
[ ] Money Order (In US Dollar only)


* We only accept credit card payments through paypal.
** Parcels will only be shipped once cheques have been cleared.

All payments to be made payable to:
'Roberta Kasnick Ripperger'.