The Goose's Nest
Online Order Form

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Refunds Are Acceptable if notified within 3 days by E-Mail and/or Phone
and returned in the same condition as purchased within 10 days.
Layaway is okay but 30 days is the limit!
Ask questions by E-Mail or telephone (503) 659-9694.

Buyer Contact Information:

    First Name: 
     Last Name: 
       Company: 
Street Address: 
          City: 
         State: 
      Zip Code: 
     Telephone: 
        E-mail: 
          

Select the Method You Wish to Pay For Your Purchase:

VISA    MASTER CARD    AMERICAN EXPRESS    DISCOVER
CASH    CHECK          MONEY ORDER         OTHER

For Credit Card Purchases, Please Supply the
Number & Expiration Date of Your Credit Card:

Card Number:

Expiration Date:

We Use SSL Secured Forms to Receive this Credit Card Information.
If You Feel Uncomfortable in Any Way Using this Online Form,
Submit this Form and Leave the Above Credit Card Fields Blank.
Then, You May Use One of these Available Options:   
v You May Send Us Your Credit Card Information Via Snail Mail by specifying below.
v You May Call Us and Tell Us Your Credit Card Information by Phone (503) 659-9694.
v You May E-Mail Us Your Credit Card Information at this address karenfixit@aol.com

Please Tell Us the Item(s) You Wish to Purchase,
and Any Comments and/or Instructions:

NOTE:
When The Goose's Nest Receives this Order Request Form,
We Will E-Mail You to Confirm the Above Order.  This will
Allow Us to Inform You of the Exact Shipping and/or Insurance
Charges that Will Be Added to the Total Price of Your Purchase,
and Discuss Any Special Details of the Sale.
If You Do Not Have an E-Mail Account, Please List Your
Phone Number So That We May Confirm Your Sale.