Beth's China Shop Order and Information Request Form... Unique hand-painted porcelain baby shoes for your new baby boy or girl!

Thank you for your interest in

Beth's China Shop

4712 Rio Bravo Court
Las Cruces, New Mexico 88007
(575) 523-7073 or Fax (575) 523-7186

Please use this form to place a secure order or to request order forms to be sent to you via mail.

Each painted shoe is $29.95 + shipping. To order more than one shoe, please complete this form for each shoe. Choose the Appropriate Shipping Option
	Domestic shipping, FREE Domestic PRIORITY shipping, $5.00 Mexico/Canada, $4.00 Mexico/Canada PRIORITY, $7.00 International shipping, $10.00 International PRIORITY shipping, $11.00 Pricing in US Dollars
Billing Address Information:
Company or Personal Name:
Billing Address:
Billing Address:
City:
State:
ZIP Code:
Country:	Type in appropriate country if not US.
Phone Number:
E-mail address:
How did you hear about our site?:
Shipping Address Information (if different from above):
Recipient's Name(s):
Shipping Address:
Shipping Address:
City:
State:
ZIP Code:
Country:	Type in appropriate country if not US.
Recipient's Phone Number:
Personalized Baby Shoe Order (Birth Announcement style):
For a:	Boy Girl
Baby's Name as it should appear on the shoe:
Birthdate:
Time of Delivery:
Length:
Weight:
Payment Options Each shoe is $29.95 + shipping . Click here to change shipping. Payment must be received before the product is sent:
Payment Choice:
VISA/MASTERCARD Number:
Expiration Date:
Name as it appears on card:
Please enter any other comments which you may have: Changes in designs will incur an additional $5.00 special order fee.

We accept Visa, Master Card, PayPal, and Personal Checks.

Make Checks Payable To:

Beth's China Shop

4712 Rio Bravo Court
Las Cruces, New Mexico 88007
(575) 523-7073 or Fax (575) 523-7186