|
Mail
to:
Country
Charm
475
Timbercrest Ct.
Cedarburg,
WI 53012 |
Name:
(Please
Print) |
| Street: |
| City: |
State: |
Zip: |
| Product
No. |
Description |
Frame
Color
Blk,
Grn, Red, Blue
|
Quantity |
Price |
Total
Price |
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$ |
$ |
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$ |
| # |
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$ |
$ |
|
Total Price |
$ |
|
Tax (5.6% WI residents) |
$ |
|
Sub Total |
$ |
|
Shipping and Handling |
Included in
continental U.S.
Please
E-mail for
other
rates. |
|
Payment Method |
Total Amount Enclosed |
$ |
| ______
Visa ______MC
______Discover ______Check |
| Card Number: |
Exp. Date: |
| Card
Holder's Name (Print) : |
| Signature:
|
|
***
Credit Cards and checks will be processed upon shipping of order
*** Please make all checks payable to Jeanie Rudich. |
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|