Order Form   

          Shipping Address:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail
URL

Billing Address:

 Same as Shipping Address?    Check Here

Name
Street Address
Address (cont.)
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Zip/Postal Code
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    Please provide the following ordering information:

QTY	DESCRIPTION	SIZE	PRICE	TOTAL
	MERCHANDISE TOTAL
	See Rate Chart Below                              POSTAGE
	Oklahoma Residents include 6.5 %       SALES TAX
	TOTAL

Priority Mail Postage Rates:                                            Registered Mail Postage Rates:

up to $19.99        =    $6.00                                                        $250.00 & up    =    $20.00

$20 to $49.99      =    $8.00                                                        

$50 to $99.99      =    $10.00

$100 to $249.99  =    $12.00

 

Send Check or Money Order with completed form to: 

                    The Jeweler's Bench

                    4716 N. MacArthur Blvd.

                    Warr Acres, OK 73122