Flutters Order Form
If you would like to order by mail, please print out and use the form below.
You may pay with your credit card or by check. All orders must be paid in US Dollars only.
Please allow 2 weeks for delivery.
Bill To: Ship To:
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Name: _____________________________ Name: _____________________________
Address: __________________________ Address: __________________________
__________________________ __________________________
__________________________ __________________________
Phone (Day): ______________________ Phone (Day): ______________________
(Eve): ______________________ (Eve): ______________________
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| | | Price | Shipping/ | |
| Quantity | Description/Size | Each | Handling | Total |
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3.5"x3.5"$14.95
| | | | 5"x5" $16.95 | |
10"x10" $19.95
larger sizes to
be determined
-------------------------------------------------------------------------
3.5"x3.5"$14.95
| | | | 5"x5" $16.95 | |
10"x10" $19.95
larger sizes to
be determined
-------------------------------------------------------------------------
3.5"x3.5"$14.95
| | | | 5"x5" $16.95 | |
10"x10" $19.95
larger sizes to
be determined
-------------------------------------------------------------------------
3.5"x3.5"$14.95
| | | | 5"x5" $16.95 | |
10"x10" $19.95
larger sizes to
be determined
-------------------------------------------------------------------------
3.5"x3.5"$14.95
| | | | 5"x5" $16.95 | |
10"x10" $19.95
larger sizes to
be determined
-------------------------------------------------------------------------
| | | | Total: | |
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Payment Method (We regret that we cannot process CODs):
___ Check (Enclosed)
___ VISA ___ Mastercard ___ Discover
Card Number: ______________________________________
Exp. Date: _____________
Signature: ______________________________________
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