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!