Order from discountneedlework.com
Print & fill out form and fax to 419.710.1328 with credit card info, or
mail with check or money order.
Send form to: |
Ship Order to: Date Rec'd:______ |
| The Cottage Discount Needlework P. O. Box 864691 Plano, TX 75086-4691 (Make checks payable to "The Cottage") |
Your Name: ________________________________ Address: __________________________________ City__________________, State_______ Zip ________ country |
Contact: (email or phone)____________________________________(important)
Credit Card Information:
VISA/MasterCard No. _______________________________________________
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 (Texas residents only) | x .0825 | |||
| 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 | $3.50 | $4.50 | $5.50 | $6.50 | $7.50 | $8.50 | 9.50 | $11.00 |