Updated: 3/1/2005
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Billing Information
Fields marked with
*
are required.
First
*
MI
Last
*
Company Name
Address Line 1
*
Must match your credit card billing address.
Address Line 2
continue address here
City
*
State
*
AA - Military
AE - Military
AK - Alaska
AL - Alabama
AP - Military
AR - Arkansas
AS - American Samoa
AZ - Arizona
CA - California
CO - Colorado
CT - Connecticut
DC - Washington DC
DE - Delaware
FL - Florida
FM - Micronesia
GA - Georgia
GU - Guam
HI - Hawaii
IA - Iowa
ID - Idaho
IL - Illinois
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MH - Marshall Isl
MI - Michigan
MN - Minnesota
MO - Missouri
MP - N. Mariana Isl
MS - Mississippi
MT - Montana
NC - North Carolina
ND - North Dakota
NE - Nebraska
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NV - Nevada
NY - New York
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
PR - Puerto Rico
PW - Palau
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VA - Virginia
VI - Virgin Islands
VT - Vermont
WA - Washington
WI - Wisconsin
WV - West Virginia
WY - Wyoming
AB - Alberta
BC - British Columbia
MB - Manitoba
NB - New Brunswick
NL - Newfoundland and Labrador
NT - Northwest Territories
NS - Nova Scotia
NU - Nunavut
ON - Ontario
PE - Prince Edward Island
QC - Quebec
SK - Saskatchewan
YT - Yukon
Zip Code
*
4 Digit Ext.
Country
-
Billing/Home Phone
*
Must match the billing address
Ext:
Daytime/Contact Phone
Ext:
Fax
Email Address
*
Example: info@greenmountainclub.org
Shipping Information
Shipping address same as billing address
.
Ship to the following address.
First
*
MI
Last
*
Company Name
Address Line 1
*
Address Line 2
continue address here
City
*
State
*
AA - Military
AE - Military
AK - Alaska
AL - Alabama
AP - Military
AR - Arkansas
AS - American Samoa
AZ - Arizona
CA - California
CO - Colorado
CT - Connecticut
DC - Washington DC
DE - Delaware
FL - Florida
FM - Micronesia
GA - Georgia
GU - Guam
HI - Hawaii
IA - Iowa
ID - Idaho
IL - Illinois
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MH - Marshall Isl
MI - Michigan
MN - Minnesota
MO - Missouri
MP - N. Mariana Isl
MS - Mississippi
MT - Montana
NC - North Carolina
ND - North Dakota
NE - Nebraska
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NV - Nevada
NY - New York
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
PR - Puerto Rico
PW - Palau
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VA - Virginia
VI - Virgin Islands
VT - Vermont
WA - Washington
WI - Wisconsin
WV - West Virginia
WY - Wyoming
AB - Alberta
BC - British Columbia
MB - Manitoba
NB - New Brunswick
NL - Newfoundland and Labrador
NT - Northwest Territories
NS - Nova Scotia
NU - Nunavut
ON - Ontario
PE - Prince Edward Island
QC - Quebec
SK - Saskatchewan
YT - Yukon
Zip Code
*
4 Digit Ext.
Country
-
Phone
*
Must match the shipping address
Ext:
Fax
Also send Email to
(Email will include item pricing)
Example: info@greenmountainclub.org
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4711 Waterbury-Stowe Rd, Waterbury Ctr, VT 05677
Tel: 802.244.7037 • Fax: 802.244.5867 • Email:
gmc@greenmountainclub.org
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