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MAIL TO (Please print): Name _____________________________________________ Address ___________________________________________ City ___________________ State ____ ZIP ______________ Day/Night phone # ____________________________________ Email (Optional-To notify you when your order is shipped) __________________________________________________ |
| QTY | ITEM | ITEM NAME | PRICE | TOTAL |
|---|---|---|---|---|
| $ |
$ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
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Total Sales => S&H $0.00-$4.99 => $2.75 $5.00-$9.99 => $3.25 $10.00-$19.99 => $4.75 $20.00 & over => $6.25 |
Merchandise total | (a) | ||
| Shipping & handling | (b) | |||
| Add a & b | (c) | |||
| Virginia residents add 4.5% of line c | ||||
| Total amount enclosed | $ | |||
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Method of Payment (Check One): Please make checks payable to QuiltSmith, Ltd. Enclosed: Check __ Money Order __ Charge My: Mastercard __ VISA __ Discover __ American Express __ Charge Account Number: _____________________________ Expiration Date: ____________________ Signature: __________________________ |
For shipments outside of the U.S., please indicate whether you prefer ground or air mail.
(There is an additional cost for air mail.)