Order Form We appreciate serving you Research Project BASIC 20 hrs ($94/hr) BASIC ONSITE 25 hrs ($94/hr) STANDARD 40 hrs ($89/hr) ADVANCED 60 hrs ($87.50/hr) PREMIUM 80 hrs ($85/hr) DISCOVERY PLAN 3.5 hrs ($100/hr) DNA DISCOVERY PLAN 3.5 hrs ($100/hr) HERITAGE TRAVEL PLAN 5 hrs ($100/hr) NONE OF THESE - Enter $ Amount Below $ Number of hours Additional Items Add Additional Research at a Discounted Rate Add 20 hours for $1750 ($87.50/hr). Add 40 hours for $3300 ($85/hr). Add Family History Chart for $40. Add Custom Designed Book (billed separately). Add a Heritage Travel Plan for $500. Add Translated Report for $200. Add Additional Payment (enter $ amount below). $ Payment Options I am paying in full. I am making a 1/3 payment and understand there is a $20 fee and that I will be automatically billed in 30 and 60 days. Discountx Payment #1 Due Today Payment #2 Due 30 Days Payment #3 Due 60 Days Order Total Click here to access currency calculator Billing Information First Name: Last Name: Phone Number: E-Mail Address: If no email address, enter firstname.lastname@example.org Street Address: City: State: Zip: Country: Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Antarctic Territory British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canton and Enderbury Islands Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos [Keeling] Islands Colombia Comoros Congo - Brazzaville Congo - Kinshasa Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Côte d’Ivoire Denmark Djibouti Dominica Dominican Republic Dronning Maud Land East Germany Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories French Southern and Antarctic Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong SAR China Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Johnston Island Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau SAR China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Metropolitan France Mexico Micronesia Midway Islands Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar [Burma] Namibia Nauru Nepal Netherlands Netherlands Antilles Neutral Zone New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea North Vietnam Northern Mariana Islands Norway Oman Pacific Islands Trust Territory Pakistan Palau Palestinian Territories Panama Panama Canal Zone Papua New Guinea Paraguay People's Democratic Republic of Yemen Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Réunion Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Saudi Arabia Senegal Serbia Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria São Tomé and Príncipe Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Minor Outlying Islands U.S. Miscellaneous Pacific Islands U.S. Virgin Islands Uganda Ukraine Union of Soviet Socialist Republics United Arab Emirates United Kingdom United States Unknown or Invalid Region Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wake Island Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Åland Islands Shipping Information (if different) Checking Account InformationAt the bottom of your check is a series of numbers, separated by symbols. It is not necessary to enter symbols or spaces in the fields provided below. Bank or Financial Institution (Not required.) Note: Some banks use a non-standard format in this series of numbers. If your account number includes this symbol, simply disregard the symbols and enter this section of numbers. By using a checking account to pay for our services you authorize Legacy Tree Genealogists to electronically debit your account for the amount specified. Effective Date of Transaction If you should need to notify us to your intent to cancel and/or revoke this authorization you must contact us 3 days prior to debit being initiated. Please call 800-818-1476. Credit Card Information Card Number: Exp. Date: January February March April May June July August September October November December   2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 Do you have a coupon code? Apply Coupon How did you hear about us? Special notes By using our services you acknowledge that you accept Legacy Tree Genealogist’s Terms of Service Agreement.