AGC Online Order Submission Form:
GIFTS & COLLECTIBLES: Over 4,000 Products Available


CUSTOMER'S NAME: CUSTOMER'S ADDRESS:
CITY & STATE: ZIP CODE:
HOME PHONE: WORK PHONE:
E-MAIL ADDRESS:



List items you want to purchase here:
(1) ITEM #: ITEM NAME:
     ITEM PRICE:

(2) ITEM #: ITEM NAME:
     ITEM PRICE:

(3) ITEM #: ITEM NAME:
     ITEM PRICE:

(4) ITEM #: ITEM NAME:
     ITEM PRICE:

(5) ITEM #: ITEM NAME:
     ITEM PRICE:

(6) ITEM #: ITEM NAME:
     ITEM PRICE:

(7) ITEM #: ITEM NAME:
     ITEM PRICE:

(8) ITEM #: ITEM NAME:
     ITEM PRICE:

(9)ITEM #: ITEM NAME:
     ITEM PRICE:

(10) ITEM #: ITEM NAME:
     ITEM PRICE:

TOTAL PRICE ON ALL ABOVE ITEMS: (Include $10.00 for Shipping & Handling.)


PAY BY CREDIT CARD
CARD TYPE: CARD NUMBER:
EXPIRATION DATE:

PAY BY CHECK
ROUTING NUMBER: ACCOUNT NUMBER:



The NAMES and ITEM NUMBERS of all products can be obtained from our CATALOGS and/or FLYERS. (Please feel free to include any comments in the space below.)

THE ARVISOM INSTITUTE

Gifts & Collectibles Division
E-Mail Contact
Arvisom Gifts & Collectibles
P.O. Box 892165
Oklahoma City, OK 73189-2165

Telephone: (888) 815-1843