Wild Canid Survival and Research Center Gift Shop Order Form

    - Simply print this form, fill it out, and mail it back to us!
 

    

 NAME: __________________________________________________________

 ADDRESS: _______________________________________________________

 CITY: _________________________ STATE: _________________________

 ZIP CODE: _____________________



 ___ My check or money order payable to the Wild Canid Center Gift Shop is enclosed.

 ___ Charge my:  ___ Mastercard  ___ Visa

     Account Number: _____________________________________________

     Expiration Date: ____________________________



     Signature: ______________________________________________  

     Date: _____________________________


 NOTE:
	US Shipping & Postage as follows:
		
	Orders to $50.00  ........... $5.00
	$50.01 to $100.00 ........... $7.00
	$100.01 and over  ........... $9.00
 	

	* Canadian buyers please add 30% currency exchange.
	* Foreign Countries: please indicate your selections
	and return form for calculation of amount due. To
	expedite your order we highly recommend Visa/MC.


	Item Number/Description			Qty		Price
      ____________________________________________________________


      ____________________________________________________________


      ____________________________________________________________


      ____________________________________________________________


						Subtotal: ________

						Shipping: ________

						TOTAL: ___________



    Mail this completed form to:

 Wild Canid Survival & Research Center
 Post Office Box 760
 Eureka, Missouri  63025


If you need more information, please
feel free to call 636-938-5900 Monday through
Friday, 9am to 5pm.