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Order Form

Order Form
Mail to: Patsee Parker
204 Carthage Ave.
Eugene, OR 97404
Phone: 541-636-4656
westlight@patsee.com

Name (Please print) _______________________________________________

Mailing Address __________________________________________________

City _______________________ State __________________ ZIP __________

Shipping Address (if different) _______________________________________

________________________________________________________________

Quantity Title Size Price Ea. Total
         
         
         
         

Total Cost

 

*Shipping & Handling

 

TOTAL

 
*Shipping cost for continental US:
    up to $60 - $10.00, $61 to $120 - $18.00
Over $121 - contact the Patsee for cost.
For shipping beyond the continental US, contact Patsee.
Special Shipping Instructions? _____________________________________

______________________________________________________________

Sorry, we no longer accept credit cards, only checks.


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