order form

Solstice Stencil

Bungalow Borders logo

ORDER FORM

Bungalow Borders
PO Box 357 • Phippsburg, ME 04562
Phone 207-389-2625 • Fax 207-389-1575

Ordered by:

Name ______________________________________

Address____________________________________

City ___________________ State ____ Zip ________

E-mail _____________________ Phone ___________

Ship to (if different from Ordered by):

Name ______________________________________

Address____________________________________

City ___________________ State ____ Zip ________

E-mail _____________________ Phone ___________

#	NAME	PRICE	QTY	EXT	#	NAME	PRICE	QTY	EXT
1	ROSE FRIEZE	$44		$	11	MEADOW	$26		$
2	GLASGOW ROSE	$44		$	12	UNITY	$88		$
3	ROSE PENDANT	$34		$	13	GINKGO BORDER	$30		$
4	TEA ROSE	$28		$	14	GINKGO FRIEZE	$42		$
5	PENDANT	$46		$	15	CHECKERBERRY	$32		$
6	RAINDANCE	$38		$	16	IVY	$32		$
7A	PRAIRIE, 10¼"	$44		$	17	PINE FRIEZE	$44		$
7B	PRAIRIE, 12"	$48		$	18	PINE BORDER	$36		$
8	SOLSTICE	$36		$	19	SCENIC BORDER	$34		$
9	REPOSE	$28		$	20	SPIRIT OF THE WOODS	$42		$
10	HARVEST FRIEZE	$36		$					$
SUB-TOTAL									$
Maine Residents Add 5% sales tax									$
Shipping & Handling: Up to $50, add $5.00 • $50.01 to $99.99 add $6.00 • Over $100 add $7.50.									$
TOTAL									$

PAYMENT METHOD
	CHECK or MONEY ORDER ENCLOSED NOTE: Orders from outside U.S.A., please pay in U.S. Funds.
	[ ] VISA	[ ] MasterCard
Name as it appears on card ______________________________________________ Card # _ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _ Expires ___/ ___ Signature _______________________________________