Printable Order Form
Only for Mail-In Orders

Please make a copy for your records.


Quantity  Description & Item Code Colour Code (refer to Colour Chart) & Size (if applicable) Gift
Package
(circle one)
Price Total
_______ _____________________ ____________________ Envelope
Plastic Box
_________ __________
_______ _____________________ ____________________ Envelope
Plastic Box
_________ __________
_______ _____________________ ____________________ Envelope
Plastic Box
_________ __________
_______ _____________________ ____________________ Envelope
Plastic Box
_________ __________

Subtotal

__________

Shipping:   for USA or Canada or International surface mail

      

            5.00

Shipping: Orders over $75.00 add $3.00

__________

Shipping: Orders over $150.00 add $5.00

__________

Shipping: add $10.00 for International air mail

__________

GRAND TOTAL

__________

Note: Prices are in US dollars.


SHIP TO:
Name__________________________________________________________________

Mailing Address__________________________________________________________

City, Prov/State, Country
and ZipCode____________________________________________________________

E-Mail Address__________________________________

Telephone (______)________________

PAYMENT METHOD:
Cheque   (Personal Cheques Must Clear The Bank Before We Can Ship)

Money Order

Visa/MasterCard/ AMEX
      Card Number _____________________ Expiry Date_______________

Signature________________________________________

Date________________________



Print the form and send your order by postal delivery to:

Amélie Silks
15639 Loyalist Parkway
R. R. #2 Bloomfield, Ontario, Canada  K0K 1G0

Please make cheques payable to Amélie Silks.
It takes approximately 1 week to process and ship orders.


Thank You!

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