Bizzotto's Order Form

Order Form

Date Phone
Check / Money Order (click here)

Name
Credit Card (click here)

Address

Address 2
Credit Card #

enter as ####-####-####

City
Exp.Date-Month Year

State Zip Code -
CREDIT CARD ORDERS CAN BE SUBMITTED ELECTRONICALLY (see below)

Quan. Item # Item & Description $$ Each Total

	Sub - Total
	Sales Tax (for Virginia residents) 4.5%
	Total
*Shipping/Handling* will be based on weight, shipping method and insurance. Please call for more information, 757-787-3103 or send email to - bizzottos@esva.net	Shipping / Handling (see info on the left)

	GRAND TOTAL

Your E-Mail Address

COMPLETE THIS FORM & CLICK ON TO SEND YOUR

CREDIT CARD ORDER TO OUR SECURE E-MAIL
-OR-
YOU CAN CALL YOUR CREDIT CARD ORDER TO 1-757-787-3103

FOR CHECKS AND MONEY ORDERS
PRINT & COMPLETE YOUR ORDER ALONG WITH PAYMENT, THEN MAIL TO -

BIZZOTTO'S GALLERY & CAFFE, 41 MARKET ST,ONANCOCK, VIRGINIA 23417, USA

Email - bizzottos@esva.net

RETURN TO BIZZOTTO'SON-LINE GALLERY

Date Phone	Check / Money Order (click here)
Name	Credit Card (click here)
Address Address 2	Credit Card # enter as ####-####-####
City	Exp.Date-Month Year
State Zip Code -	CREDIT CARD ORDERS CAN BE SUBMITTED ELECTRONICALLY (see below)