Byers_Choice_Order

Christmas Spirit
Limited Edition: Byers' Choice Ltd. Reporter Caroler
Figurine made exclusively for the Burlington County Times, Bucks County Courier Times and The Intelligencer

Please note: * Denotes required information.
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First Name:*

Last Name:*

E-mail Address:*

Phone (day):*

Phone (evening): (if different)

Example 555-555-5555

Street Address:*

Apt.# or P.O. Box: (if applicable)

City:*

State:*

Zip:*

Credit Card Type:*

	Visa
	MasterCard
	American Express
	Discover

Credit Card Number:*

(Example: xxxx-xxxx-xxxx-xxxx)

Expiration Date:*

(Example: 12/12)

If different than above, enter information as it appears on credit card.

Name:

Address:

City:

State:

Zip:

Please note: * Denotes required information.

Please indicate in the box below the number of Byers' dolls and which newspaper the doll is holding (Burlington County Times, Bucks County Courier Times or The Intelligencer):*

Special Instructions* Please indicate in the form below which newspaper lobby you will be picking up the doll (BCT, BCCT, or Intelligencer)

Total number of dolls:*
@ $76.00 (includes tax & shipping) or $69.00 if picking up at newspaper lobby = Total Cost:*

Pleas click SUBMIT only once. If you have a question about your order please call (609) 871-8153.