Michigan Basset Rescue Merchandise Order Form

Thank you for purchasing your basset collectibles and wearables from Michigan Basset Rescue. 100% of the profit for every purchase you make helps us to provide the best possible care for our rescued bassets.


Name
E-mail
Address
City
State Zip Code
Home Phone

Work Phone 

Country


Special requests or instructions.

Please make sure that you check the web pages for sizes and availability before ordering

Product Code Number Size Color Quantity Item Cost
Example: 1301 L Navy 1 25.00
        --------
Subtotal
Shipping - US Priority 1 Item (except for oversize Items) $5.05
Add $1.00 for each additional item
MBR Logo Denim Jacket - $8.55
     Shipping for Oversize Items (Lg. Sitting or Lying Basset, Basset Pillow)  $10.95
      --------
Grand Total
Due to fraudulent activities MBR will only accept credit card orders within the United States and Canada.
Only certified USA cashier checks with mail-in orders will be accepted as payment for out of the country.

Credit Card # Exp. date

Please fill out the information then highlight the form and in the print dialog box click selection and then okay for print

Sign your name after you and finished printing the form

Signature ____________________________________________________

For checks, money orders or credit card orders, please print form and mail along with your payment to:

Michigan Basset Rescue
PO Box 300381
Waterford, MI 48330-0381

For questions about merchandise, email us.

MBR Home

updated June 15, 2009