Patsy's Hemp Creations
Order Form

Please fill out the following information and press the SUBMIT button


* = REQUIRED FIELD

* Name
* Address1
Address2
* City, State, Zip
* E-mail Address
* Phone Number
* Method of Payment
* Item #1 - Qty
* Item #1 - Item Number
Item #1 - Description PLEASE MEASURE YOUR BODY PART AND GIVE SIZE HERE - Please give as many details as possible and note subsititutions and bead choices here. If it's going to be CUSTOM - you have got to tell me what you want. Be specific and make sure I have a phone number to contact you if I have questions.
* Item #1
Price Each
* Item #1
Total
Item #2 - Qty
Item #2 - Item Number
Item #2 - Description
Please give as many details as possible and note subsititutions and bead choices here.
Item #2
Price Each
Item #2
Total
Item #3 - Qty
Item #3 - Item Number
Item #3 - Description
Please give as many details as possible and note subsititutions and bead choices here.
Item #3
Price Each
Item #3
Total
Item #4 - Qty
Item #4 - Item Number
Item #4 - Description
Please give as many details as possible and note subsititutions and bead choices here.
Item #4
Price Each
Item #4
Total
Item #5 - Qty
Item #5 - Item Number
Item #5 - Description
Please give as many details as possible and note subsititutions and bead choices here.
Item #5
Price Each
Item #5
Total
Shipping Charges: Please add $2 for every 1-5 items
ORDER TOTAL



Copyright © 2001 Patsy A. Brown

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