MUSEUM SHOP ORDER FORM 

Print the following form and mail us your order with payment to: 
          Tioga County Historical Society
          110 Front Street, Owego, New York 13827 

$4.00 shipping chages. New York State residents must add 8.0% sales tax.  Members receive a 10% discount. Please allow 2-3 weeks for delivery.

 
Name__________________________________________________

Address_________________________________________________

City______________________State__________Zip_____________

Phone____________________ E-mail_________________________

Item(s)                                                             Qty       Price

_______________________________________________________
_______________________________________________________
_______________________________________________________

Total amount enclosed (Including tax & shipping)  $ ________________

Form of payment: ____check/money order ____Visa ____Mastercard

Card number__________________________________Exp.date________
Signature____________________________________________________

$4.00 shipping charges, 8% sales tax for NYS residents