Fine, Handcrafted Pewter in the Great American Tradition
Small Wine Coaster

Printable Order Form

To place an order, you may print out this form and mail it to us with your check or credit card information. You may also download the form as an Adobe Acrobat PDF file and print copies from that. For more information, contact me.

Send Orders To: Gibson Pewter, 26 North Main Street, Washington, NH  03280. Or call: (603) 495-1776

Billing Address: SHIP TO:



City, State, Zip

Daytime Phone



City, State, Zip

Daytime Phone

____ Enclose gift card to say:
Shipping Charges:
Up to $50 add $12.00
$50 to $75 add $15.00
$75 to $150 add $18.00
$150 to $200 add $20.00
each+ $50.00 add $3.00

Please note: Shipping fees are subject to change, based on current UPS prices


Payment Method: (Please check one)  ____Visa  ____MasterCard

Card Number & Expiration Date

Name printed on card & Signature

____ Personal or company check made payable to Gibson Pewter enclosed.

TERMS: All orders prepaid with placement by Check or Money Order payable to Gibson Pewter or include Credit Card information. Delivery is normally within 1-2 weeks. We can send gifts for you directly with gift card. See above instructions. We ship via UPS so please use street address rather than Post Office Box whenever possible.


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