ORDER FORM

Ship To:

Date:

Mailing Address:

 

 

Daytime Phone:

E-mail Address:

QTY

STYLE #

DESCRIPTION

AMOUNT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUBTOTAL

 

U.S. orders LESS than $30, Add $3.OO

 

7.5% TAX (New Mexico addresses ONLY)

 

TOTAL CHARGES

 

DISTINCTIVE PIECES • P.O. BOX 90335 • ALBUQUERQUE, NM 87199-0335 • (505) 821-5588