Mr. Doobie's Gifts By Mail
P.O. Box 413 - Burlington, Washington 98233
Print this form for mailing in your order to us.


(A) Sold To: (Your name and address)

Name: ____________________________________

E-mail: ________________________________

Street Address: ___________________________

____________________________________

City:________________ State:___ Zip:________

Daytime Telephone:_______________________

(B) Ship To: (if different from sold to)

Name: ____________________________________

Street Address: ___________________________

____________________________________

City:________________ State:___ Zip:________

Delivery Address Telephone:_____________________

(C) Gift List:

Item Name: Size: Color: Quantity: Price per Item: Total:
_____________________________________ _____ __________ ________ ___________ _________
_____________________________________ _____ __________ ________ ___________ _________
_____________________________________ _____ __________ ________ ___________ _________
_____________________________________ _____ __________ ________ ___________ _________
_____________________________________ _____ __________ ________ ___________ _________
_____________________________________ _____ __________ ________ ___________ _________
_____________________________________ _____ __________ ________ ___________ _________

(D) Totals, Taxes, Shipping:

Merchandise Total:________
WA State Residents: add 7.8% Sales Tax on merch. delivered in WA:________
Shipping (see chart):________
International Shipping (see below*):________
purchase amount: shipping:
up to $9.99 add 45.00%
$10.00-$49.99 add 25.00%
$50.00-$99.99 add 20.00%
$100.00-$199.99 add 15.00%
$200.00 and up add 10.00%
TOTAL:_______

EXAMPLE: 1 Mr. Doobie Book = $19.95 x .25 (25.00%) = $4.98 shipping
(E) Method of Payment:
___Certified Bank Check or Postal Money Order's ONLY (payable to "William J. Beck")

*For international shipping quote, please email admin@mrdoobie.com the list of products you wish to purchase and the location to where you would like them to be mailed.

To pay by credit card, please click the link below and use our online store through PayPal!
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