WILD GRACES
Order Form

Click here to print order form.

Name   _________________________________________________
Address _________________________________________________
City      _________________________________________________
State/Zip ________________________________________________
Phone  __________________________________________________
Email   __________________________________________________

STAINED GLASS - Note: please contact for availability before ordering
Item Name _________________________________________  price $__________________
Item Name _________________________________________  price $__________________

WOODCUT PRINTS
Item Name ______________________________  qty____ total price $__________________
Item Name ______________________________  qty____ total price $__________________
Item Name ______________________________  qty____ total price $__________________
Item Name ______________________________  qty____ total price $__________________

SHIPPING & HANDLING: $28 Shipping & Handling, including insurance and delivery confirmation to addresses in the 48 Contiguous United States for each stained glass. $6.95 for prints  regardless of quantity. Sorry, Wild Graces does not ship its fragile stained glass to any other locations.

Select Method of Payment (circle one)  
Check Money Order
Visa Mastercard
Discover American Express
Subtotal  $ _________________
Shipping $ _________________

      Total $ _________________

Credit Card Number __________________________________________
       Expiration Date ___________ Security Code __________________

  (on front or back of credit card)

To order call (603) 463-3073 Or print this order form, fill out, mail with
payment or credit card info to:

WILD GRACES
111 Nottingham Road
Deerfield, NH  03037

 

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