Reilly's Treasured Gold ordering form

Fill in the form below, print it out and fax it to us or
mail it to us. Fax number: 1-954-971-0575


Name:

Email address:

Shipping address:

Apt. # or suite #:

We need a street address to ship your orders by U.P.S.


City, state & zip:

Country:

Telephone number:

Special instructions for shipping to another address:

Item No. - quantity - Item and Description - Our Price:


Sub total:

Shipping charges:
Add $9.00 for s&h for all orders up to $35.00
Add $14.00 for s&h for all orders from $35.01 to $70.00
Add $20.00 for s&h for all orders from $70.01 to $99.99
Add $25.00 for s&h for all orders from $100.00 to $149.99
Add $30.00 for s&h for all orders from $150.00 to $199.99
Free s&h on all orders over $200.00 in U.S. only! (48 states only)
Shipping & Handling on all International orders are shipped by U.S. Postal Service & are billed by a credit card number.


Add shipping charges:

Florida resident add sales tax:

Total enclosed:



Please charge to my (choose one card): Visa MC Discover AMEX


Card Number

Name on card:

Expiration Date:
(mm/yyyy) /

CVV2 number located on back of card:
(Last 3 digits for Visa, Discover & Mastercard. American Express is 4 digits on front of card.)

Card Bank name:


Signature:


Make check or Money Orders payable to : Reilly's Treasured Gold, Inc.


Mail your order to:
Reilly's Treasured Gold, Inc.
2003 W. Mc Nab Road #10
Pompano Beach, Fl. 33069
Phone 1-954-971-6102
FAX 1-954-971-0575
Ordering line 1-800-876-6102


Got questions? Email us at rtgsales@rtgstore.com

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