Order Form
Order Form
Mail to: Westlight Gallery
5174 SW Pacific Coast Hwy.
Waldport, OR 97394
westlight@patsee.com
Name (Please print) _______________________________________________
Mailing Address __________________________________________________
City _______________________ State __________________ ZIP __________
Shipping Address (if different) _______________________________________
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Size |
Price Ea. |
Total |
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Total Cost |
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*Shipping & Handling |
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TOTAL |
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*Shipping cost for continental US:
up to $60 - $6.00, $61 to $120 - $8.00
Over $121 - contact the Gallery for cost.
For shipping beyond the continental US, contact the Gallery.
Special Shipping Instructions? _____________________________________
______________________________________________________________
Charge to my Mastercard( ), Visa( ), Discover Card( )
Card Number ________ ________ ________ ________ Expires ____/____
Signature _____________________________________
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