|
|
| Billing | Shipping |
|---|---|
| Name | Name |
| Telephone | Address |
| Street | Street |
| City | City |
| State, Zip | State, Zip |
| A gift from | Ship to arrive by |
| Company Name: | Your E Mail Address: |
| Card # - Expiration Date |
| Signature |
| QUANTITY | PRODUCT | PRICE | AMOUNT |
|---|---|---|---|
| Rustic | 34.00 | ||
| Cascade | 36.00 | ||
| Swag | 32.00 | ||
| Regal | 46.00 | ||
| Deluxe | 38.00 | ||
| - | - | ||
| - | - |
| Add 7.7% sales tax for items shipped to Washington addresses only |
| Deduct 10% if you order 10 or more products. |
| Total Amount: |