|
Order
form for payment by check or money order
|
|
price |
| Your Name |
Jane Doe |
|
| Your Email Address |
jdoe@imaginary.net |
| phone number |
(555) 321-1234 |
| screensaver1 (put set on one line) |
Kitty Ballet / Kitty Heaven set |
15 |
| screensaver2 (put set on one line) |
Set of all 3 Butterflies |
20 |
| screensave3 (put set on one line) |
Soul Babies / Disco Baby Set |
15 |
| screensaver4 (put set on one line) |
|
|
| screensaver5 (put set on one line) |
|
|
| |
Subtotal
|
$50 |
| discount (circle one): * |
|
$50
|
$100
|
$150
|
$200
|
|
30%
|
50%
|
55%
|
60%
|
|
$15 |
| |
Total
|
$35 |