Ck, MO,
MC, Visa,
Dis, AE Accepted
|
Please Send Order to:Designs
by Patty |
or GO TO: www.designsbypatty.com to place order. |
Ck, MO,
MC, Visa,
Dis, AE Accepted
|
Please Send Order to:Designs
by Patty |
Return to MY PATTERNS
CUSTOMER INFORMATION:
| Date: _______________ _ ________________________________________ | ||||
| Email Address (If applicable): | ||||
| First & Last Name: | ||||
| Day & Evening Phone # (include area code): | ||||
| Street Address: | ||||
| City / State / Providence: | ||||
| Country: Postal Code / Zip: | ||||
FORM OF PAYMENT: _____Check _____ Money Order _____ Credit Card
|
Qty ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ |
Item # __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ |
Product Name/Description _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ |
Price _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ Sub Total Sales Tax Shipping - TOTAL |
Total Price __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ $_________ $_________ $_________ $_________ |
