FROM: (Your information) Name_____________________________________________
Phone ( ___ ) ____________________
Street____________________________________ Apt. ______________________
City______________________________________ State ______ Zip
___________
___ VISA ___ MASTERCARD
Card #________________________________
Exp. Date _______________
Signature______________________________
___ CHECK OR MONEY ORDER
SEND ME: ______ # DECORATED
Wreaths;
_____ # UNDECORATED Wreaths
Single Centerpieces: ______ #Red, ______ #Blue
Triple Centerpieces : ______ # Red, ______ #Blue
|
|
|
|
|
|
|---|---|---|---|---|
|
|
DECORATED WREATHS -- EASTERN U.S. | $28.95 | = | _____________ |
|
|
UNDECORATED WREATHS -- EASTERN U.S. | $20.50 | = | _____________ |
|
|
DECORATED WREATHS -- WESTERN U.S. | $29.95 | = | _____________ |
|
|
UNDECORATED WREATHS -- WESTERN U.S. | $21.50 | = | _____________ |
|
|
SINGLE CENTERPIECES -- EASTERN U.S | $24.95 | = | _____________ |
| _________ | TRIPLE CENTERPIECES -- EASTERN U.S | $33.95 | = | _____________ |
| _________ | SINGLE CENTERPIECES -- WESTERN U.S | $25.95 | = | _____________ |
| _________ | TRIPLE CENTERPIECES -- WESTERN U.S | $34.95 | = | _____________ |
| MAINE residents, please Add 5% Sales Tax. |
TAX |
=
|
_____________ | |
| ORDER TOTAL: | TOTAL: |
=
|
_____________ |