O’Shea’s Market Ireland

United States Order Form

Ordering Instructions:
To Order by fax or by mail, please print out and complete this order form, include all pertinent order information and payment option.

By FAX

Fax to our 24 hour fax order line at 1-613-594-0122

By Mail

Mail to :
O'Shea's Market Ireland Inc.
Internet Order Department
808 Commerce Park Drive.
Ogdensburg, N.Y. 13669

Shipping Information:

	Ship To:	Sold To: (Same as Ship to (__))
Name
Address
City
State/Zip Code
Phone	Day : (___-___-____) Evenings (___-___-____)	Day : (___-___-____) Evenings (___-___-____)

Catalogue #	Qty	Item Description	Size	Color/Pattern	Price








		Total Order
		New York State residences only (add local Sales Tax)
		Shipping and handling (see Shipping information )
		Amount Due :

Payment Option:

(__) MasterCard

(__) VISA

(__) AMEX

(__) Bank Draft

Card Number

Expiry Date

(____/____)

Signature