For email, copy and paste this information into an email "Compose" message; fill in the information and then mail to oding4@yahoo.com. Or print off form and mail to the address above
Ordered by: Order Date: ______________
Name_________________________________________________
Mailing Address_______________________________________________
City____________________________State __________________Zip___________________
Daytime Telephone No. __________________________Evening Phone No. _______________
____VISA _____MC Credit Card Account No. _______________________________
Expiration Date ________ Customer
Name as if appears on Card________________________
Gift Certificates Available !
| Order Code | Description | Glass Color / Gold or Silver Metal | Quantity | Item Price | Total |
| / | / | / | / | / | / |
| / | / | / | / | / | / |
| / | / | / | / | / | / |
| / | / | / | / | / | / |
| / | / | / | / | / | / |
| SubTotal | / / |
| Shipping Charges will be exact charges as applied by UPS or USPS, plus insurance -plus $3. handling charge | / |
| NE residents
- add sales Tax for
your local area |
/ |
| Total | / |
| Ship to:
Name___________________________________ Address_________________________________ City ____________________State_________Zip________ Item Nos.__________________________ Gift Card Message______________________________
|
Thank you for your purchase. We wish
you many hours of joy and happiness with your new possession.
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Wild Grove Designs / Copyright, 1999
Gretchen Olberding
All images & all rights reserved