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Use This Form For Mail In Orders / Use CASH SALES Secure Internet Order Form For Credit Card Orders
Order Form

Shipping Address:                                                                                        Billing Address

Name:           Name:
Street (NO P.O. BOX):           Street:
City:           City:
Prov./State:           Prov./State:
Postal/Zip Code:           Postal/Zip Code:
Country:           Country:
Phone Number:           Phone Number:
e-mail:           e-mail:

Credit Card Information:

Credit Card Type: Name on credit card:
Credit card number: Security Code # 3-4 digit code
Expiry date (MM/YY): Signature:

Products To Order:

Item # Description Quantity Price Line Total

Sub-Total:
Shipping : (See Below):
Taxes: Michigan Residents add 6% MI Sales Tax:
GRAND TOTAL:
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MAIL TO: Robinson's Antiques 119 Lincoln Lake, Lowell, MI. 49331

Shipping Charges include signature requested
(for Continental U.S. only, international orders will be charged accordingly)

$0.01 to $49.99 Add $8.95 2nd Day Add $42.95 Next Day Add $52.95
$50.00 to $99.99 Add $10.95 2nd Day Add $45.95 Next Day Add $55.95
$100.00 to $149.99 Add $13.95 2nd Day Add $48.95 Next Day Add $58.95
$150.00 to $199.99 Add $15.95 2nd Day Add $52.95 Next Day Add $62.95
$200.00 to $299.99 Add $18.95 2nd Day Add $59.95 Next Day Add $69.95
$300.00 to $499.99 Add $27.95 2nd Day Add $64.95 Next Day Add $74.95
$500.00 to $999.99 Add $32.95 2nd Day Add $86.95 Next Day Add $96.95
$1000.00 to $1999.99 Add $36.95 2nd Day Add $109.95 Next Day Add $122.95
$2000.00 to $2999.99 Add $52.95 2nd Day Add $149.95 Next Day Add $169.95
$3000.00 to $3999.99 Add $66.95 2nd Day Add $202.95 Next Day Add $222.95
Based on rates; Extra Distance Cost Or Large or Heavy Packages May Require Additional Postage