Retail Store Order Form
Mail Orders: Girl Scouts of Northern California, 7700 Edgewater Drive, Suite 340, Oakland, CA 94621
Phone: (510) 562-8470 | FAX Orders: (510) 633-7925 | E-mail Orders: ShopOakland@GirlScoutsNorCal.org
Local Retail Store:
Person Placing Order Telephone (Include Area Code)
q Eureka q Redding q Chico q Oakland
q San Jose q Fairfield q Santa Rosa
Troop # or q Juliette Girl Scout Date Ordered Program Level:
Orders will be processed within 3-5 working days.
q Daisy q Brownie q Junior
Orders are limited to stock availability. q Cadette q Senior q Ambassador q Adult
Quantity Catalog # Size or Color Description Unit Price Dollar Amount
Store Policy Tax $
No exchanges, credit or refunds will be made after 30 days of purchase.
You must have a receipt for exchanges, credit or refunds.
Total Order $
Name: (print)_____________________________________________ q Troop #: __________ q Juliette
Address: _____________________________________________________________________________ Local sales tax will be added.
Shipping & Handling
Payment Options: (Excludes Tax):
q Check #__________ q VISA q American Express q Master Card q Discover q Cookie Card Shipping and Handling
To ensure the security of your information, we will call you on the telephone to get your credit card information. charges will be the cost
of the shipping plus the
The best time (Monday-Friday 9-5) to call you is: ______a.m. _____p.m. q Mon q Tues q Weds q Thurs q Fri
shipping materials used
Phone #:(______) __________________Signature ___________________________________________ (envelope, box, etc.).
Ship To (if different from above): Note: There is an additional
charge for books that are
Name: (print)__________________________________________________________________________ shipped due to their weight.
FOR GSNC OFFICE USE ONLY Order Online!
Date Authorization # For Credit Card Visit our online store at
Order Mailed q Phone Order q UPS q US Mail http://store.GirlScoutsNorCal.org
8x 02/2011 STORE MARCOMM