Offline Order Form
Please print this order form, fill in the information and submit your order along with your payment. Thank you!
SHIPPING - Where you are sending the order.
Name:
Address:
 
City:                                                      State:                  Zip:
Phone:
PAYMENT - The person paying for the order. 
Name:
Address:
 
City:                                                      State:                  Zip:
Phone:                                                                Email:
*Please provide us with your phone and/or email so we may contact you with any questions regarding your order.
Name on credit card:
Credit Card Number:
Type of Card (Visa, Master Card, Amex, Diner's Club or Discover:
Expiration Date:______/______/______
ORDER FORM
Item No. Qty. Product name, description Unit Price Total
         
         
         
         
         
         
*Please use a separate sheet for additional items.
Comments / Other: Sub-Total  
  NY Sales Tax
New York Residents @ 8.375%		  
Shipping Charge
(See www.montgomerypens.com/shipping.asp for rates)		  
ORDER TOTAL  

Signature:
I authorize Montgomerypens.com to ship and collect payment for the products ordered above.
*If you pay by credit card, we cannot ship your order without your signature.
Submit via fax: 212-420-0480
Submit via mail: Montgomery Stationary 330 Grand St. New York, NY  10002