Bentley and Buddies Adoption Form

Bentley and Buddies Adoption Form To remove a Bear, set Quantity "no". To save it for another order, set Quantity "0", check "Save" below.

Quan	Code	Item Title	Price	Total

			Subtotal
Ship to: US/Canada		Missouri address: Cass County Other county	MO sales tax
Ship to: US/Canada		Outside Missouri: United States Canada	Shipping, Handling, & Insurance
Another Country		Surface: All other countries	Total
Another Country		AirMail: Americas Europe Asia/Africa Pacific Rim
		Save the list of items (for 90 days only) so I can come back later.

Billing Address Shipping Address (if different)
Name:
Company:
Address:
City,St,Zip:
Country:
Email: (required)

I send all my bears out with information about Good Bears of the World, but if you do not want this information please check this box:

Payment
Method: Credit card: - - - Expires: / (eg 12/04)
Discover, MasterCard, Visa (At this time we can't secure this information, please enter all 1's and call us with you Card Number)
I am sending my name, credit card number, and expiration date separately.
I am sending a check or money order.
(Note: we cannot process your order until we receive your check or money order.)


Adoption
Notes:


You can also print this form and mail or fax it to us, or phone in your order.
Mail: Nancy & Doug Dane, 32 Iris Lane, Belton, MO 64012
Phone: 816.322.2038

Thank you for your Adoption!

	Billing Address	Shipping Address (if different)
Name:
Company:
Address:
City,St,Zip:
Country:
Email:	(required)

	I send all my bears out with information about Good Bears of the World, but if you do not want this information please check this box:

Payment Method:	Credit card: - - - Expires: / (eg 12/04) Discover, MasterCard, Visa (At this time we can't secure this information, please enter all 1's and call us with you Card Number)
	I am sending my name, credit card number, and expiration date separately.
	I am sending a check or money order. (Note: we cannot process your order until we receive your check or money order.)


Adoption Notes:


	You can also print this form and mail or fax it to us, or phone in your order. Mail: Nancy & Doug Dane, 32 Iris Lane, Belton, MO 64012 Phone: 816.322.2038


Thank you for your Adoption!