Mail this form to:
Marcia's Dollclothes
965 Chopmist Hill Road
North Scituate, RI 02857
(401) 647-0414
ORDERED BY:
Name
Address
City
State
Zip
Daytime Phone
Evening Phone
Email Address
SHIP TO:
(if different)
Name
Address
City
State
Zip
GIFT BOX WITH CARD:
(add $2.50)
To:
From:
Item#
Description
Color
Qty
Price Each
Total
ex: 001
Cape
Red
2
$15.00
$30.00
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Merchandise Total
Shipping
Insurance
$0.00 - $50.00
$5.00
$1.70
$50.01 - $75.00
$6.00
$1.70
$75.01 - $100.00
$7.00
$1.70
Merchandise Total
$
USPS Priority Mail Shipping
$
Insurance
(optional)
$
Gift Box/Card
$
Total Amount Enclosed
$
Thank you for your order!
Please make your check or money order payable to
Marcia's Dollclothes
.
