Lost Aussie - Series 1 - Collage Sheet Order Form

Just print out this page, fill it out and send it with your personal check or money order - in US dollars - to the address below. Please make your check out to "Marie Otero."

Marie Otero, 13100 Kensworth Court, Charlotte, NC, 28277

Item
Quantity
Price
Total
... Collage Sheet LA 001
 
$4.50
$
... Collage Sheet LA 002
 
$4.50
$
... Collage Sheet LA 003
 
$4.50
$ 
... Collage Sheet LA 004
 
$4.50
$ 
... Collage Sheet LA 005
 
$4.50
$ 
... Collage Sheet LA 006
 
$4.50
$ 
... Collage Sheet LA 007
 
$4.50
$ 
... Collage Sheet LA 008
 
$4.50
$ 
... Collage Sheet LA 009
 
$4.50
$ 
... Collage Sheet LA 010
 
$4.50
$ 
... Collage Sheet LA 011
 
$4.50
$ 
... Collage Sheet LA 012
 
$4.50
$ 
... Collage Sheet LA 013
 
$4.50
$ 
... Collage Sheet LA 014
 
$4.50
$ 
... Collage Sheet LA 015
 
$4.50
$ 
... Collage Sheet LA 016
 
$4.50
$ 
... Collage Sheet LA 017
 
$4.50
$ 
... Collage Sheet LA 018
 
$4.50
$ 
... Collage Sheet LA 019
 
$4.50
$ 
... Collage Sheet LA 020
 
$4.50
$ 
Subtotal   $ 
NC residents ONLY add 7 1/2% sales tax   + 
USA orders add $3.85 for standard shipping
International orders please contact me for rate 		 + $3.85
Grand Total   $ 

Billing address:
Name: ____________________________________________________
Address:   _________________________________________________
City:__________________________ State:________  Zip:__________
Country (if outside the USA):__________________________________
In the event I have a back order, I will email to let you know.
Email address (or phone number): ______________________________

Shipping address (if different from billing address):

Name: ____________________________________________________
Address:   _________________________________________________
City:__________________________ State:________  Zip:__________
Country (if outside the USA):__________________________________

Marie Otero