World Collectible Center
21-21 41st. Ave Loft #4C
Long Island City, NY 11101
PHONE: (718) 472-1536
FAX: (718) 472-2632

Order Form

              Date:

Shipping Information: (please type or print)
Name:
Billing Address (must be credit card billing address):
City:                                                                 State:                       Zip:
E-mail Address:                                                              Daytime Phone:
Shipping Address (if different than Billing address):
City:                                                                 State:                       Zip:
Item Name Price Each Qty Amount
       
       
       
       
       
       
       
       
       
       
       
       
       
SubTotal  
NY Residents add 8.25% Sales Tax to SubTotal (Other states put 0)  
Shipping and Handling  FREE!
Total  
Billing Information:     ___Check         ___Money Order         ___Visa         ___MasterCard
                                         ___Discover    ___Amex                  ___JCB

            Credit Card Number__________________________________   Expiration Date________
            Name as it appears on Card___________________________   Billing Zip Code________
            Signature______________________________________

Make checks payable to: World Collectible Center Inc
If you have any questions concerning this order form, email: WorldCollectibles@yahoo.com

THANK YOU FOR YOUR BUSINESS!