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Order Form From Liza's Reef Online Store
FREE SHIPPING IN USA -$5.00 SHIPPING TO THE WORLD
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ITEM |
PRICE |
QUANTITY |
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Gold Queen Angel
Cloisonné Enamel Earrings |
$15 |
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Gold Queen Angel Cloisonné Enamel Earrings |
$15 |
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10 Assorted Liza's Reef Postcards |
$ 8 |
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Print "Full Moon Rising |
$20 |
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SUBTOTAL: |
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NC
residents add 6.75% tax |
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Add $5 Shipping if outside
USA |
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TOTAL DUE: |
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Name:____________________________________________________________________
Address Line
1:____________________________________________________________
(Post Office Address only please)
Address Line
2:____________________________________________________________
City:________________________________State or Province:______________________
Zip Code:_____________ Country:_____________________
Phone (Home):_(____)___________________Phone (Work):(____)__________________
email:_________________________________Fax:________________________________
(Will be used only for contact purposes by author)
Shipping Information
(Complete only if different from above)
Name:____________________________________________________________________
Address Line
1:____________________________________________________________
(Post Office Address only please)
Address Line
2:____________________________________________________________
City:________________________________State or Province:______________________
Zip Code:_____________ Country:_____________________
SEND PAYMENT
TO:
Lee Pantas /18 Garren Mountain Lane /Fairview, NC 28730,
USA
828-779-1569
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