Star Wishing Fax & Mail Order Form to name a star

Star Information

Please fill out this form completely and accurately to ensure a correct listing. Click on the link next to the field for more information. DO NOT use all capitals. Print out form and fax (credit cards only) or mail (credit cards or checks) it to us.

Person Star is Named After :

Your Wish (examples)
(maximum 60 characters):

Giver's Name:
(example: Love, John)

Date Of Occasion (required):

/ / Example - 01/Jan/2003

LIST OF CONSTELLATIONS
Random: A constellation will be chosen at random but we prefer that you please choose ONE from this list.
Andromeda, The Princess Antlia, The Air Pump Aquarius, The Water Bearer Aquila, The Eagle Ara, The Altar Auriga, The Charioteer Boötes, The Bear Driver Caelum, The Sculptor's Chisel Camelopardalis, The Giraffe Cancer, The Crab Canes Venatici, The Hunting Dogs Canis Major, The Great Dog Canis Minor, The Little Dog Capricornus, The Sea Goat Carina, The Ship's Keel Cassiopeia, Queen Of Ethiopia Centaurus, The Centaur Cephius, King Of Ethiopia Cetus, The Sea Monster Chamaeleon, The Chameleon Columba, The Dove Coma Berenices, Berenice's Hair Corona Austrina, The Southern Crown Corona Borealis, The Northern Crown Corvus, The Crow Crater, The Cup Crux, The Southern Cross	Cygnus, The Swan Delphinus, The Dolphin Dorado, The Swordfish Draco, The Dragon Equuleus, The Foal Eridanus, The River Fornax, The Laboratory Furnace Gemini, The Twins Grus, The Crane Hercules, Hercules The Hero Horologium, The Clock Hydra, The Water Serpent Hydrus, The Water Snake Indus, The American Indian Lacerta, The Lizard Leo, The Lion Leo Minor, The Lion Cub Lepus, The Hare Libra, The Beam Balance Lupus, The Wolf Lynx, The Lynx Lyra, The Lyre Mensa, The Table Mountain Microscopium, The Microscope Monoceros, The Unicorn Musca, The Flying Insect Norma, The Carpenter's Square Octans, The Octant Ophiuchus, The Serpent Bearer Orion, The Great Hunter	Pavo, The Peacock Pegasus, The Winged Horse Perseus, The Hero Phoenix, The Phoenix Pictor, The Painter's Easel Pisces, The Fishes Piscis Austrinus, The Southern Fish Puppis, The Ship's Stern Pyxis, The Compass Box Reticulum, The Net Sagitta, The Arrow Sagittarius, The Archer Scorpius, The Scorpion Sculptor, The Sculptor's Workshop Scutum, The Shield Serpens, The Serpent Sextans, The Sextant Taurus, The Bull Telescopium, The Telescope Triangulum, The Triangle Triangulum Australe, The Southern Triangle Tucana, The Toucan Ursa Major, The Great Bear Ursa Minor, The Bear Cub Vela, The Ship's Sail Virgo, The Maiden Volans, The Flying Fish Vulpecula, The Fox

Enter A Constellation from the above list:

Is this for a memorial?

No Yes

Your Email (yours@example.com):

Shipping Information

(Please include complete shipping Name and Address to ensure prompt and accurate delivery. Use the ENTER key to start a new line.)

Shipping Name and Address:

Click ONE Button To Select The Gift Package You Want.
All orders to Mexico MUST choose an International Express Option. Payment must be in US DOLLARS Only.

	Ship it:	within U.S.			Internationally
Holiday Deadlines		Select	Days	Total	Select	Days	Total
Star Gift Package	Standard		4-6	$39.95		7-21	$49.95
Star Gift Package	Express		1-3	$55.95		5-7	$59.95

Star Package & Miniplanisphere	Standard		4-6	$49.90		7-21	$59.90
Star Package & Miniplanisphere	Express		1-3	$65.90		5-7	$69.90
If ordering express shipping, please enter phone number of delivery address. Used only if the postal service has trouble finding the address:

Standard: Standard shipping is FREE for orders shipped within the US. Standard International shipping is available for an additional $10.
Express: If you need it quicker than our standard shipping, we also have USPS Express Service. Express Shipping is not available to APO's.

Payment Information (Visa, American Express, Discover, or MasterCard)

NOTE:

Please make sure to enter the same information that your credit card company has on you or else your order will be declined. Call your credit card company first if you are not sure if the information is up to date. Thank you.

Fax Orders:

Print & Fax
Form to
702-543-7003

Your Name As On Card:

____________________________________

Your Signature:

____________________________________

Credit Card Number:

____________________________________

Expiration Date:

____________________________________

Billing Address, City, State, & Zip:

____________________________________

Billing Phone Number:

____________________________________

Mail Orders Only

Make payment payable to: EcoPlanet. Checks must be in US Dollars and be encoded at the bottom of the check. Mail Form & Check To:
EcoPlanet - Star Wishing, PO Box 1491, Glendora, CA 91740 USA

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