Wildflowers Unique Books & Gifts

Printable Order Form

 Name:

______________________________________________________    

 Address:

______________________________________________________

 City/State/Zip:

______________________________________________________

 Phone #:

______________________________________________________

 

PRODUCT NAME & ITEM #  (We need both to process)  

  QTY  

  PRICE  

  TOTAL  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

       

   

    

       Sub-Total

 

      West Virginia only customers add 6% Sales Tax

 

Shipping  

      $6.95

                                                                                                            Total

 

 

CREDIT CARD TYPE________________ Cardholder Name______________________________________ NUMBER___________________________________________________ EXPIRATION DATE____________ SIGNATURE_______________________________________________________________ DATE__________
Cash or money order payable to:

Wildflowers
1512 Oakhurst Drive
Charleston, WV 25314