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The Kentucky Quilt Company |
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ORDER FORM |
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1575 Campbell Lane, Bowling Green, KY 42104 |
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e-mail: ajbenham@scrtc.com |
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FAX: 270-678-7924 |
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Retail phone: 270-842-2434 |
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Date: |
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Name: |
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Address: |
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City, State, Zip |
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Phone: |
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E-mail: |
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Credit Card Payment: |
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Number |
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Expiration Date |
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VIN No. |
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Circle One: |
Master Card |
Visa |
Discover |
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Item Number |
Description |
Unit |
Quantity |
Total Price |
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Price |
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Items |
Total |
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S & H |
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Total |
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Shipping & Handling: |
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$0-25 |
$5.95 |
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$25.01-50 |
$7.95 |
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$50.01-75. |
$9.95 |
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75.01-125 |
$11.95 |
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$125.+ |
$13.95 |
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