Manual Order Form

Visa or Mastercard only

Please do not send checks, as we cannot determine the postage rates until we know the weight of your order and your postal zone. You will be charged for actual postage only. No handling charges will be added.

Print and mail to: Bryerpatch Studio PO Box 945 Oswego, IL 60543

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ITEM                        QTY PRICE TOTAL
       
       
       
       
       
       
       
       

SUBTOTAL

     

Illinois Residents add 6.25% Sales Tax:

     

SHIPPING  & HANDLING

   

see below *

GRAND TOTAL:

   

depends on
shipping charges

* SHIPPING & HANDLING USA:  Your account will be charged for the actual cost of shipping your order. 
    Orders will be shipped by     US Priority Mail or UPS ground

*INTERNATIONAL SHIPPING & HANDLING:   Your credit card will be charged for the actual amount of the international shipping charges. 
   All international orders will be shipped by US Postal Service Air Mail unless other arrangements have been made.

Ship to

Credit Card Information

NAME: NAME as it appears on your credit card:

 

STREET ADDRESS: STREET ADDRESS:

 

CITY/ST/ZIP: CITY/ST/ZIP:

 

COUNTRY: COUNTRY:
PHONE: CREDIT CARD  #:

 

EMAIL: EXPIRATION DATE   #:
  YOUR SIGNATURE: