Community Stained Glass Bevel Cluster Order Form
To order, complete and mail to: Community Stained Glass, 2701 Ripple Ct., White Lake, MI 48383. Or fax to: (248)684-4151. Questions or order by phone (248) 684-1153.
Name_________________________________________________
Shipping Address________________________________________
______________________________________________________
Telephone Number ( ) _____ - ________________ ext. ________
| Item Number | Item Description | Quantity | Price Per Item | Total |
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Sub Total |
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Michigan residents add 6% Sales tax |
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Shipping/Handling (World wide shipping add $9.85 for 1st item $3.00 each additional item) |
$4.99 $1.00 each additional item |
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Total Amount |
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*Please make checks or money orders payable to: Community Stained Glass, Inc.
*Please enclose check, money order, or furnish credit card information
| Credit Card Payments:
circle one
Name as it appears on card:________________________________________ Credit Card No.:_________________________________________________ Expiration Date:_________________ Phone No.:_______________________ Signature X____________________________________________________
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