Porcelains by Nicole

Instructions:  Print this form with your browser's "print" button, complete the form

fax the order (860) 721-6688  or call  (860) 721-6688 
Name  
Address1  
Address2  
City/State/Zip  
Date  
Phone #  
Fax #  
E-mail  
Quantity Type Description Breed and/or color Unit Price Total Price
           
           
           
           
           
           
           
           
           
           
           
example: 2 lapel pins Tuxedo cats black and white    
shipping and handling add 10% up to $199.99 Merchandise Total
free shipping   on orders $200.00 and over Shipping & Handling
Subtotal
CT state tax 6% on merchandise total without shipping (CT tax)

3 credit logos.jpg (5163 bytes) We appreciate your business, thank you, Nicole

 TOTAL
Method of Payment (Circle One)     Visa  MasterCard   Discover  Check   Money Order 
Credit Card Number  __ __ __ __ -- __ __ __ __ -- __ __ __ __ -- __ __ __ __
Expiration Date Signature