PATTI'S DOLLS PATTERN ORDER FORM
Patti LaValley . 68591 Whitney Rd . Rainier, OR 97048
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  
ITEM NAME:   QTY:   PRICE:  

SUBTOTAL:

  

SHIPPING:

  

GRAND TOTAL:

  

SHIPPING AND HANDLING RATES
 
QTY 1 QTY 2 QTY 3+
 

USA PRIORITY
$1.25 $2.50 $3.60
 

UK GLOBAL PRIORITY

 $5.00  

AUS GLOBAL PRIORITY

 $6.00  

CUSTOMER INFORMATION

NAME:_____________________________________________________________________________________

ADDRESS:_________________________________________________________________________________

STATE:_______________________________________________________ ZIP: _________________________

COUNTRY:___________________________________

PHONE:(_____)_______________________________

EMAIL: ______________________________________

ENCLOSED PAYMENT

    

MONEY ORDER

CHECK

AMOUNT:_____________________

~ THANK YOU ~