ORDER FORM
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Item # |
Description:
house,
hospital, chapel etc. |
Personalization:
print exactly as you want it to appear |
Color
request |
Price: |
Total: |
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Thank
you for your order!
Each
Memory Lane Village is handmade and carefully personalized. You should receive your order within
3-4
weeks.
Merchandise Subtotal: ____________
| Shipping & Handling | |
|
Mdse Total |
Add |
|
Up to $14.95 |
$4.95 |
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$15.00-$24.99 |
$5.95 |
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$25.00-$44.99 |
$6.95 |
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$45.00-$64.99 |
$7.95 |
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$65.00-$84.99 |
$8.95 |
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$85.00-$104.99 |
$9.95 |
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$105. -$124.99 |
$10.95 |
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$125. -$144.99 |
$11.95 |
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$145. and over |
$12.95 |
Shipping
& Handling $_____________
Order Total: $__________
1. Personal Check or
Money Order: (Payable to
LORI BRANCH)
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Your Name: |
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Address: |
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City: State: Zip: |
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Phone: ( ) |
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Email: (customer info is never released to third parties) |
Send orders via email or by mail.
Current Mailing Address:
1418 Andover Court
Evans,
Georgia 30809
© 2003 Memory Lane Villages