Celtic Lands Order Form

Fill out the form below and click 'Transmit Order' to email your order to Celtic Lands. Alternatively, you can phone us on (513) 321-9782 (EST) or, if you have any questions email us at emrys@fuse.net				VISA and Mastercard accepted                      ** Credit card payments are made         via our secure server.         For your security, all credit card         information is encrypted **

Item List

Item No.	Item Description	Quantity	Price
Select From List CC01D CC01L CD1 CD2 CM1 CM2 CM3 CM4 CM5 CM6 CM8 CM9 DJ01 DJ02 DJ03 DJ05 DJ06D DJ06L JW001 JW044 JW049 JW051 JW053 JW054 JW055 JW057 JW058 JW059 JW061 JW063 JW070 LS079 LS082 LS102 LS104 LS114 LS119 LS121 LS127 LS152 LS154 LS156 LS157 LS158 LS162 LS163 LS165 PC1 PC10 PC105 PC108 PC14 PC15 PC16 PC24 PC28 PC31 PC33 PC34D PC34L PC45 PC48 PC49 PC54H PC54T PC55 PC56 PC60 PC60A PC72 PC73 PC77 PC78 PCCWG PCCWI PCCWJ pin3Fthrs1 pin3Fthrs2 pinDragon1 pinDragon2 pinLeek pinR pinWA pinWE pinWI TI001 TI002 TI003 TI004 TI005 TI006 TI007 TI008 TI009 TI010 TI011 TT002 TT003		0 1 2 3
Select From List CC01D CC01L CD1 CD2 CM1 CM2 CM3 CM4 CM5 CM6 CM8 CM9 DJ01 DJ02 DJ03 DJ05 DJ06D DJ06L JW001 JW044 JW049 JW051 JW053 JW054 JW055 JW057 JW058 JW059 JW061 JW063 JW070 LS079 LS082 LS102 LS104 LS114 LS119 LS121 LS127 LS152 LS154 LS156 LS157 LS158 LS162 LS163 LS165 PC1 PC10 PC105 PC108 PC14 PC15 PC16 PC24 PC28 PC31 PC33 PC34D PC34L PC45 PC48 PC49 PC54H PC54T PC55 PC56 PC60 PC60A PC72 PC73 PC77 PC78 PCCWG PCCWI PCCWJ pin3Fthrs1 pin3Fthrs2 pinDragon1 pinDragon2 pinLeek pinR pinWA pinWE pinWI TI001 TI002 TI003 TI004 TI005 TI006 TI007 TI008 TI009 TI010 TI011 TT002 TT003		0 1 2 3
Select From List CC01D CC01L CD1 CD2 CM1 CM2 CM3 CM4 CM5 CM6 CM8 CM9 DJ01 DJ02 DJ03 DJ05 DJ06D DJ06L JW001 JW044 JW049 JW051 JW053 JW054 JW055 JW057 JW058 JW059 JW061 JW063 JW070 LS079 LS082 LS102 LS104 LS114 LS119 LS121 LS127 LS152 LS154 LS156 LS157 LS158 LS162 LS163 LS165 PC1 PC10 PC105 PC108 PC14 PC15 PC16 PC24 PC28 PC31 PC33 PC34D PC34L PC45 PC48 PC49 PC54H PC54T PC55 PC56 PC60 PC60A PC72 PC73 PC77 PC78 PCCWG PCCWI PCCWJ pin3Fthrs1 pin3Fthrs2 pinDragon1 pinDragon2 pinLeek pinR pinWA pinWE pinWI TI001 TI002 TI003 TI004 TI005 TI006 TI007 TI008 TI009 TI010 TI011 TT002 TT003		0 1 2 3
Select From List CC01D CC01L CD1 CD2 CM1 CM2 CM3 CM4 CM5 CM6 CM8 CM9 DJ01 DJ02 DJ03 DJ05 DJ06D DJ06L JW001 JW044 JW049 JW051 JW053 JW054 JW055 JW057 JW058 JW059 JW061 JW063 JW070 LS079 LS082 LS102 LS104 LS114 LS119 LS121 LS127 LS152 LS154 LS156 LS157 LS158 LS162 LS163 LS165 PC1 PC10 PC105 PC108 PC14 PC15 PC16 PC24 PC28 PC31 PC33 PC34D PC34L PC45 PC48 PC49 PC54H PC54T PC55 PC56 PC60 PC60A PC72 PC73 PC77 PC78 PCCWG PCCWI PCCWJ pin3Fthrs1 pin3Fthrs2 pinDragon1 pinDragon2 pinLeek pinR pinWA pinWE pinWI TI001 TI002 TI003 TI004 TI005 TI006 TI007 TI008 TI009 TI010 TI011 TT002 TT003		0 1 2 3
Select From List CC01D CC01L CD1 CD2 CM1 CM2 CM3 CM4 CM5 CM6 CM8 CM9 DJ01 DJ02 DJ03 DJ05 DJ06D DJ06L JW001 JW044 JW049 JW051 JW053 JW054 JW055 JW057 JW058 JW059 JW061 JW063 JW070 LS079 LS082 LS102 LS104 LS114 LS119 LS121 LS127 LS152 LS154 LS156 LS157 LS158 LS162 LS163 LS165 PC1 PC10 PC105 PC108 PC14 PC15 PC16 PC24 PC28 PC31 PC33 PC34D PC34L PC45 PC48 PC49 PC54H PC54T PC55 PC56 PC60 PC60A PC72 PC73 PC77 PC78 PCCWG PCCWI PCCWJ pin3Fthrs1 pin3Fthrs2 pinDragon1 pinDragon2 pinLeek pinR pinWA pinWE pinWI TI001 TI002 TI003 TI004 TI005 TI006 TI007 TI008 TI009 TI010 TI011 TT002 TT003		0 1 2 3
Select items from the drop-down lists above		Subtotal:
		Shipping:
		TOTAL:
		( all amounts are in $ US )

Customer Details

Name:		( required )
Address:		( required )
E-mail:		( required )
Phone:
Mailing address: ( if different from above )

Payment Details

Payment Method:	Personal Check
	Credit Card
	( if payment is by credit card, please fill out the following fields )
Credit Card Type:	VISA MASTERCARD
Credit Card Number:
Expiration Date:	Month  01 "02" "03" "04" "05" "06" "07" "08" "09" "10" "11" "12"   Year  2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Exact Name on Card: