Order by Mail - Just print form, fill out, and drop in the mail.
Name:_______________________________________________________
Shipping Address:______________________________________________
City/State/Zip:_________________________________________________
Please fill in one of the following if you wish an order confirmation:
Phone:___________________________ E-mail___________________________
QTY ___Item Name & Number ______PRICE PER ITEM TOTAL
_____ ___________________________________ _________ _________
_____ ___________________________________ _________ _________
_____ ___________________________________ _________ _________
_____ ___________________________________ _________ _________
_____ ___________________________________ _________ _________
SUBTOTAL _________
Pay-by-Mail Discount - Subtract 20% _________
(contact for amount if needed)
SHIPPING FREE!
Shipping Insurance (if desired) _________
*GRAND TOTAL _________
*Please pay this amount.
Please send order form and payment to:
Victoria Heilshorn Studio
1323 Bavarian St.
Bryan, OH 43506
(Please use more than one form if more space is needed)
Thank You!