HEATHERS STUDIO ORDER FORM
Heather Walker
po box, ut 84088
Phone or FAX:

Print this form and fill it out. If you cannot print it directly from the web, save it on your computer, then print it.
Enclose check or charge information.
Send it to the above address or FAX it to 801-000-000

Ordered by:
Name:_________________________________________________________________________

Address:_______________________________________________________________________

City:__________________________________________________State_______Zip___________

Phone: Day (____)_________________________Evening: (____)________________________

Please include your Email address:________________________@___________________________

so that we can notify you of the shipment date.

.....................................................................................................................................................................................................

Item Description_________________________________Quantity___Item Price____Total Cost

1. ________________________________________...._____.......... _______........_________

2. ________________________________________...._____.......... _______........._________

3. _________________________________________...._____........ _______...... _________

Sub-Total___________________

Sales Tax (Ut residents add 5.5%) _______________

Shipping and Handling (see chart)_______________

TOTAL_______________________

Payment :

Check or money order payable to Heathers Studio. Check enclosed..#___________
..........................................................................................................................................

MasterCard_#______________________________Visa_#_________________________________

Name on the card_______________________________________________Exp. date____/___/_____

Signature_____________________________________________________________________
........................................................................................................................................