Print-able Order form

PRINT THIS ORDER FORM AND MAIL WITH PAYMENT INFORMATION TO: Primitive Pieces by Lynda 4638 W Kelly Park Road Apopka, Florida United States 32712 Phone #: 407 886-6069 Fax #: Email: Piecemaker51@aol.com
Circle Payment Method: Check Money Order VISA MasterCard
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Address:	Email:
City:	Credit Card Number:
State & Zip:	Expires:
Telephone:	Signature:_____________________

Item Name and Description	Quantity	Price














Subtotal:
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Florida residents must add 6% sales tax-
MAKE CHECKS PAYABLE TO: Primitive Pieces by Lynda	Total :

Thank you for shopping at Primitive Pieces by Lynda.