ORDER FORM
Prototype Coins, Medals, & Tokens by Moonlight Mint and Daniel Carr
These items can be ordered by visiting www.dc-coin.com , or by mailing this order form to the address shown below.
Please see other catalog pages for catalog numbers, item descriptions, and prices.
Write catalog number, brief description, price, quantity, and total on each line below.
Note: Items with prices listed as “Sold Out” or “N/A” are not available.
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Product Total: |
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Flat-rate insured shipping $5 USA ($10 international) per order, regardless of the number of coins |
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Grand Total With Shipping: |
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Prices and availability are subject to change without notice.
Paypal orders accepted at: www.dc-coin.com .
Paypal payments can also be sent directly to: dcarr@DesignsComputed.com
Please send order form, along with credit card info, check, or money order, payable to:
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Designs Computed P.O. Box 7486 Loveland, CO 80537-0486 USA |
970-667-7610 info@DesignsComputed.com |
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Credit card orders (shipping address must be the same as billing address) |
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Card Type ___ Visa ___ Master Card ___ Discover |
Card Number
___ ___ ___ ___
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Expiration Date
___ / ___ |
Signature (for credit card orders only)
__________________________ |
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Shipping |
* Optional Fields ----------------------------------------------------------- |
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NAME |
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* TELEPHONE |
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ADDRESS |
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* COMMENTS |
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