“JOURNEY'S END” Gift Shop Order Form
                                                                                
Mail or Fax orders to:  Worldways Children's Museum
555 Spirit of St. Louis Blvd, Chesterfield, MO 63005
* (636) 207-7405 * Fax (636) 532-3750
Billing Information                                                           Shipping Information (if different)

Name  Name

Address________________________________
______________________________________
______________________________________
Phone  (       ) ________________________
email  ______________________________

Address___________________________________
_________________________________________
_________________________________________
Phone   (       ) ____________________________
email  ___________________________________

Billing Preference:   ____         ____           Check #______________  
Account #___________________________________   Exp. Date______/______
Print Cardholder Name_______________________________________________
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Item #

Description

Qty

Size/Color

Weight

Price

Total

Shipping & Handling Charges (See Chart Below)

Sales Tax

$00.00

Grand Total

Shipping & Handling Charges:
1oz to 5oz = $3.00
5oz to 1 lb = $5.00
1 lb to 3 lbs = $7.00
Over 3 lbs = $10.00 (Flat Fee)

Signature________________________________________________________Date__________________
Thank you for supporting Worldways’ mission through your purchases!