Celtic Connection
Electronic Check Order form

Use this form only if paying by Electronic Check.

IMPORTANT NOTICE:
Our webmaster Herne, passed away on Wednesday, July 9 2003. This site will be maintained by his family in his memory. We will be answering as much of his email as we can and will continue to process your orders from the catalog. If you have an outstanding order that has taken more than 30 days to receive, PLEASE CONTACT US so we can check into it for you.
Thank you for your support.
Kardia

If you have any questions, refer to the Payment instructions or Order FAQ links before filling out this form. It may prevent your order from being delayed!

PayPal Instructions    Postal & E-Check Instructions    Order FAQ    Return Policy    Main Index
Name
Address
City
 State/Province
Country
 Zip/Post Code
Phone
 Email Address
Item # Size Qty Item Description Price Total
Merchandise Sub Total  
S&H    (Select Correct Amount From Drop Down Window)  
TOTAL  
Method of Payment: (Check this box to confirm payment by Electronic Check) Electronic Check
Electronic Check Information  (U.S. Orders Only)
Not for Debit or Credit Card payments.
All fields are required.
Account Name(s) exactly as they appear on your checks including middle initial if applicable.
 Name1     Name2  
Bank Name:  Bank Address: 
City:  ST:  Zip:  Bank Phone: 
Enter the 9 digit bank routing number followed by your account number (usually 9-14 more numbers)in the box below. We need all these numbers to create a valid bank draft.
9 Digit Routing #:   Acct #:  Check #:  Drivers License #: Issuing State: 
All payments must be in US funds only!   There is a $32.00 fee for all NSF or Returned Checks.
Orders paid by Electronic Check held for 15 business days.
Make sure all information and totals are correct before clicking submit. Incorrect information in the payment sections will cause long delays.

Do not click Submit more than once to avoid multiple debits to your account.

   
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