Retail Order Form
Date:_________
Simple
      Pleasures
Cynthia Tomaszewski - Quilt Designer
Within the United States
3923 28th St. S.E. #241
Grand Rapids, MI 49512
Phone/Fax: (616) 891-7234
Outside the United States
P.O.Box 42401
Abu Dhabi, United Arab Emirates
Phone/Fax: 971-2-681-5909


http://www.simpleas.com/
Email: cynthia@simpleas.com

Ordered By: Ship To: (If different than Ordered By)
Name: Name:
Address: Address:
City:                                           St: City:                                           St:
Ph:                                   Zip: Ph:                                   Zip:
Fax No: Fax No:

Qty. Item # Description Price Total
     
     
     
     
     
     

Shipping:
      Within the U.S.: Add 10% of subtotal (Minimum: $2.00)
      Canada: Add $6.00 + 10% of subtotal
      International: Add $10.00 + 10% of subtotal

      For each book in your order, also add $1.70
SUBTOTAL:
SHIPPING: (See Above)
TOTAL AMOUNT DUE:
Prices subject to change without notice.






Please print and complete this form.
We accept personal check, cashiers check, or money order.

Please contact us for our wholesale price schedule.

Thank you for your order!
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