Order Form
Ordered By:                                                                       Ship to: (If different from Ordered by)
Name: _______________________________   Name : _________________________________
Address: _____________________________  Address: _______________________________
City: __________  State: _______ Zip: ______  City: ____________  State: _______ Zip: ______
Telephone __________________

            Make Checks Payable To: 

   David Clough Designs

            Mail All Orders To:

 

   David Clough Designs
   4 Concord Circle
   Cumberland Foreside,  Me.  04110

            To Place An Order By Phone, Or Fax: 

   (207) 781-2156

Description Quantity Amount Total
       
       
       
       
       
       
       
       
       
Please Check :

Personal Checks    ___
Money Orders       ___
Delivery Charges

Up to $25.00        $11.00
$25.01 - $50         $13.50
$50.01 - $75         $17.50
$75.01 - $100       $19.50
$100.01 - $200      $25.00
$200.01 and over   $15% of Total

Express Shipping

Up to $25.00        $19.00
$25.01 - $50         $21.00
$50.01 - $75         $25.00
$75.01 - $100        $28.00
$100.01 - $200      $35.00
$200.01 and over   $20% of Total

Subtotal

 Sales Tax  (For Me. 5%)
Delivery Charges
Grand Total
Phone Orders Accepted

9:00 AM til 5:00 PM 
Mon. thru Fri
East Coast Time

 

All contents copyright    by David Clough. All rights reserved.