Ste. Anne Gift Shop
Item Description
Size
Color
Quantity
Price
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X
X
X
X
X
X
X
X
X
X
X
X
X
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Shipping Charges
Up to $10.00
add $2.00
$10.01 - $19.00
add $4.00
$19.01 - $30.00
add $6.00
$30.01 - $40.00
add $8.00
$40.01 - $50.00
add $10.00
Merchandise Total Amount:
XXXXXXX
Shipping Charge:
X
Grand Total:
X
Make checks payable to Ste. Anne de Detroit
NAME:
X
MAILING ADDRESS:
X
CITY:
X
STATE:
X
ZIP:
X
PHONE:
X
or
Credit Card Information
VISA/MASTERCARD #:
X
EXPIRATION DATE: (xx/xx)
X
SIGNATURE:
X
Mail this form with payment
or credit card information to:
Ste. Anne de Detroit
Christmas Gifts
1000 Ste. Anne St.
Detroit, MI 48216
