METHOD OF PAYMENT

___ Check (Made out to California Heritage Museum)

___ Visa ___ Master Card

Name as appears on card: _______________________________________

Card account number: __________________________________________

Expiration Date (MM/DD/YY) : ______________

SHIPPING INFORMATION

Name: _____________________________________________________

Company: ______________________ Phone Number: (          )

Street Address: ______________________________________________

City: ______________________ State: _______ Zip Code: ___________