Shop Order Form

Please fill out entire form.

Please allow 1-2 weeks to delivery of in-stock items.

In event of backordered items, delivery may take up to 6 weeks.

You will be notified of all backorders.

If you do not wish to submit online, you may print out this form, fill it out and send it directly to

Girl Scouts of the Sierra Nevada, Attn: Shop Order

FAX: (775) 322-0701 or

MAIL: 605 Washington Street, Reno, Nevada 89503.

Contact Information
Full Name: *
Address: *
City: *
State: *
Zip Code: *
Home Phone: *
Cell Phone:
Email Address: *
Comments:
Shipping Information
If Different from Contact - Full Name:
Mailing Address:
City:
State:
Zip Code:
Order Information
Quantity: *
Catalog Number: *
Description (Color, Size, etc) *
Price: *
Total Cost: *
Quantity:
Catalog Number:
Description (Color, Size, etc)
Price:
Total Cost:
Quantity:
Catalog Number:
Description (Color, Size, etc)
Price:
Total Cost:
Quantity:
Catalog Number:
Description (Color, Size, etc)
Price:
Total Cost:
Quantity:
Catalog Number:
Description (Color, Size, etc)
Price:
Total Cost:
Total Due
Total Order Amount: *
Shipping & Handling: *
Total Amount Owed - No Sales Tax *
Online Payment
Credit Card: *
Cardholder Full Name: *
Credit Card Number: *
Card Expiration Date: *
Security Code: *
Card Billing Zip Code: *