Mountain Country Store
A Division Of Country Creek Furniture & Gifts

Online Secure Order Form

We Accept the following Forms of Payment
Checks On Line, Fax, Phone, or by Mail 
Credit Cards - Master Card, Visa, Discover, Am Express 
Money Orders By Mail
      Customer Information
      (Billing Information)
      *First Name:
       *Last Name:
 *Billing Address:
    *Billing City:
   *Billing State: Billing Country:
     *Billing Zip: -
*Destination Type:
            *E-mail:
       *Day Phone:
     *Night Phone:
        Fax Phone:

Type any additional instructions involving your order such as a Gift Card Message if appropriate

       *The fields marked with (*) are mandatory
 
       Ship To Information
       (If Different Than Billing Address)
       *First Name:
        *Last Name:
 *Shipping Address:
    *Shipping City:
   *Shipping State: Country:
     *Shipping Zip:-
*The fields marked with (*) are mandatory
 
 Item  # Description
Qty
 Price
 Amount
See Shipping Charges Below SHIPPING
SUB TOTAL
*North Carolina Residents 6%  SALES TAX*
TOTAL DUE

 
 
 
SHIPPING CHARGES

All items are shipped freight prepaid and the shipping charges are added to the invoice.  Because of the variable density and sizes of our many items, it is not possible to establish a shipping charge that would apply equally to all items.  Therefore, actual shipping costs will be quoted at the time of order placement

We ship via U.S. Postal, UPS, Emery Air or Ground Service Freight.  The carrier will be selected to obtain the best shipping rate and delivery service to your destination.

            We Offer Several Ordering Options
Secure Server
SSL Encrypted

     1.  Use our Online Secure Server for:
                Credit Card Orders, or
                Check by Internet orders

     2.  You can use your browser to print this page, fill it out, and then
          Fax, Phone or Mail it to us:

                                       Franklin, NC Store:
                                               2142 Georgia Road - Hwy 441 S
                                               Franklin, NC 28734
                                               Toll Free: 888-52-CREEK  (888-522-7335)
                                               Local  828-524-9377
                                               Fax: 828-349-4847 (avail. 24 hr/7days)

                                          (Enclose Check or Money Order When Mailing Your Order)
                                           (Credit Card Or Checks Only For Fax or Phone Orders)

      
 
        Creditcard Information
Credit Card Type:
     Card Number:
       Exp. Date:/
    Name on card:
 
 
         Check By Internet Information
   Available For U. S. Residents Only

 *Exact Name On Check:
    2nd Name On Check:
             *Address:
               *City:
              *State:
                 *Zip:-
        *Check Number:
             *Amount:

  Pay To The Order Of:   Country Creek Furniture & Gifts
      *Numbers From
      Bottom Of Check:

                *Memo:

           *Bank Name:
          *Bank Phone:
        *Bank Address:
           *BankCity:
          *BankState:
            *Bank Zip:-