Pirate Document Order Form

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Order Your Document

Any Document $24.95~~Any Framed Document $39.95

1. Select your document
Enter the name of your document as it appears on the web page. Please be accurate as many documents have similar names.
Document title: *

2. Personalize your document

Select one:
Do not personalize my document. I want historic names and places. (Go to Step 4)

Personalized my document.
a. Copy the names you want to personalize from the web page to the window below.
b. Then enter the new names you'd like to have on your document right next to them.
c. Enter any special requests here also.
d. Please double check your entries for accuracy.

Example for *1779 Riches and Honor*: 1. Ship Name Revenge 2. Harbor Name Key West 3. Captain Name Howdy 4. Tavern Name Ed's Bar & Grill
If this document is for theatrical use and will be subject to excessive handling ask for the flexible sealing wax (free).

4. Order and Ship Your Document

Order Enter price for you option
Documents Only	$24.95	$
Framed and beautifully mounted Wooden Frames	$14.95	$
Code Duello three pages 1777 (Framing not available)	$39.95	$

Shipping & Handling
Documents Only (First class mail)	$2.25	$
Framed Document (Priority Mail)	$9.45	$

Total Order and Shipping

5. Contact Information
Please provide the following contact information in case there is a question about your order
We do not sell your information or store your credit card numbers.
Email Address:*
Phone number:

6. Credit Card Information

Card holder's name	*
Card holder's address	*
Card holder's address 2
City	*
State/ Province	*
Zip/ Postal Code	*
Country	*
Credit Card Type	*
Card Number	*
Expiration Date Month	Year *
*Indicates required field

6. Ship To A Different Address
Ship to different address

Name
Street Address
Street Address
City
State/ Province
Zip/ Postal Code
Country

You will receive an Order Confirmation page after you submit.
If you do not receive that page please email us: CaptConch@piratedocuments.com