Order Form

Using this Form:

Print and mail to:

Dragonfly Design
1115 Madison Street NE
PMB#503
Salem, OR 97303

OR

Fax to (503) 588-5007

Please be sure to fill in all required lines, indicated by *

*Name

*Street Address

*City
*State
*Country
*Zip Code

*E-Mail Address
*Phone #
Payment Method:
Please Note:
Checks will be allowed to clear before orders are shipped.
Credit cards will not be charged until your order is ready to ship.
Credit Card:
Credit Card Number

Expiration MO/YR
Cardholder name as it appears on card
Qty Item Code Item Name Color/Size Price Each Ext. Price
Shipping: Please see chart below.
TOTAL
Comments:

Shipping and Handling

Most orders are shipped 3 day priority mail. Rush delivery is available, Call or E-Mail for rates. For foreign orders, e mail for exact shipping and handling.




For U.S. Orders Totaling-  Add-
Up to $10.00 ............. $6.95
$10.01 - $30.00 .......... $7.95
$30.01 - $50.00 .......... $9.95
$50.01 - $70.00 .......... $12.95
$70.01 and over .......... $15.95

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Copyright © 2004 by Dragonfly Design Studio