Order from discountneedlework.com
Print & fill out form and fax to 469.374.8737 with credit card info, or
mail with check or money order.
Send form to: |
Ship Order to: Date Rec'd:______ |
| LRC Discount Needlework 11410 NE 124th St, #637 Kirkland, WA 98034 |
Your Name: ________________________________ Address: __________________________________ City__________________, State_______ Zip ________ country |
Contact: (email or phone)____________________________________(important)
Credit Card Information:
VISA/MasterCard No. _________________________________________CVV code:____
Expiration Date: ____________ Name on Card:
____________________________
Signature: ______________________________________
| Quantity | Color | Item No./Description | Price Ea. | Total Price |
|---|---|---|---|---|
| Subtotal | ||||
| Shipping (from below - email for rates on oversized or international orders) | ||||
| Tax (WA residents only) | x .065 | |||
| Total amount included |
| Purchase | 0- $5 | $5-10 | $10.01-30 | $30.01-50 | $50.01-70 | $70.01-90 | $90.01-110 | Over $110 |
| Shipping | $3.75 | $5.00 | $6.00 | $7.00 | $8.00 | $9.25 | 10.00 | $11.50 |