Printable Order Form

Quantity	Description & Item Code	Colour Code (refer to Colour Chart) & Size (if applicable)	Gift Package (circle one)	Price	Total

_______	_____________________	____________________	Envelope Plastic Box	_________	__________
_______	_____________________	____________________	Envelope Plastic Box	_________	__________
_______	_____________________	____________________	Envelope Plastic Box	_________	__________
_______	_____________________	____________________	Envelope Plastic Box	_________	__________
Subtotal					__________
Shipping: for USA or Canada or International surface mail					5.00
Shipping: Orders over $75.00 add $3.00					__________
Shipping: Orders over $150.00 add $5.00					__________
Shipping: add $10.00 for International air mail					__________
GRAND TOTAL					__________

Note: Prices are in US dollars.

SHIP TO:
Name__________________________________________________________________

Mailing Address__________________________________________________________

City, Prov/State, Country
and ZipCode____________________________________________________________

E-Mail Address__________________________________

Telephone (______)________________

PAYMENT METHOD:
Cheque (Personal Cheques Must Clear The Bank Before We Can Ship)

Money Order

Visa/MasterCard/ AMEX
Card Number _____________________ Expiry Date_______________

Signature________________________________________

Date________________________

Print the form and send your order by postal delivery to:

Amélie Silks
15639 Loyalist Parkway
R. R. #2 Bloomfield, Ontario, Canada K0K 1G0

Please make cheques payable to Amélie Silks.
It takes approximately 1 week to process and ship orders.

Thank You!