CNMA Printable Order Form

CNMA Printable Mail Order Form: To order, please mail or fax this form, telephone, or e-mail us.

CNMA
Colorado National Monument
Fruita, CO 81521

Telephone: (970) 858-3617 ext. 308
Fax: (970) 858-0372
E-Mail: COLM_CNMA@nps.gov

Name________________________________________________________ Date ________________

Address*___________________________________________________________________________

City____________________________________ State________________ Zip___________________

Daytime Telephone (_____)_____________________ E-Mail ________________________________

Method of Payment: Check ______ (please mail to CNMA with this form) Credit Card ______

MC/Visa/Discover/American Express #________________________________ Exp. Date_________

Credit Card Security Code (from back of card) ________________

Credit Card Holder Signature__________________________________________________________

Quantity

__________

Description

____________________________________________

Unit Price

__________

Total

_______

Shipping & Handling

$0 - $14.99.................$5.75
$15.00 - $29.99...........$6.75
$30.00 - $44.99...........$7.75
$45.00 - $64.99...........$8.75
$65.00 - $119.99.........$12.00
$120 and above...........$16.00

Compute Charges

Merchandise Subtotal: _________
CNMA Members Deduct 15%: _________
Colorado Residents Add 2.9% State Sales Tax: _________
Mesa Cty. CO Residents Add 2% Cty. Sales Tax: _________
Add Shipping: _________

Total: _________

*Foreign Delivery is available. Additional charges apply. Please contact us for an exact quote.