Midwest Gift World - Online Submit Order Form

Item Number	Description	Quantity	Price Each	Amount Due

		Subtotal:
Missouri Sales Tax add 6.475%	.......................	Sales Tax:
$2.50 Small Order Fee if Subtotal is under	$45.00..........	Small Order Fee
See chart below	.......................	Shipping:
		Total Due:

Packing & Shipping Chart

(Within the Continental U.S.)

Up to $45.00 subtotal	.........................................	$6.95
$45.01 to $54.99	.........................................	$13.75
$55.00 to $74.99	.........................................	$18.75
$75.00 to $99.99	.........................................	$24.99
$100.00 to $599.99	.........................................	add 21% of Subtotal
$600.00 plus	.........................................	add 15% of Subtotal

Airmail

(Alaska, Virgin Islands, Guam, Puerto Rico, and Hawaii)

Subtotal up to $45..........$19.95

Over $45...............add 46% of Subtotal

DHL Rush (Cont. U.S. Only)

Subtotals under $45.00..........$21.50

$45.01 to $505.00...........49% of Subtotal

$505.01 and over.........44% of Subtotal

Name and address must match what is on file with your credit card company

(Due to security reasons, we will only ship to this address)

Street Address:

City:
State:
Zip/Postal:
Country:
Day Telephone:
Fax:
	.
Credit Card:
Exact Name On Card:
Credit Card Number:
Expiration Date:	-
3 or 4 digit Card ID Code:	(See Sample Below)

Yes, I certify that I am the person who placed this order on the internet at the web site: www.midwestgiftworld.com. I certify that the credit card used to purchase this order belongs to me and I have the authority to make purchases with it. I agree to pay the total amount of this order according to my credit card issuer agreement, and that my name and address will be verified as the EXACT billing information that is on file with my credit card issuer.

Most merchandise is processed and shipped directly from our California warehouse. Therefore, finalized orders can not be cancelled or changed. Please make sure all the information you have provided is correct. You will receive an email confirmation soon. Allow 10-14 days for normal ground delivery.

Dec	FEB	May
	12
2003	2005	2006