Quilters' Express Catalog Order Form

Please print out and fax to 570-522-7480 or mail to address below.
Contact Information
Name:
Address:
City:
State: Zip:
Country:
Daytime Phone:
e-mail:
Two Methods of Payment
1. Check or Money Order in U.S. Funds for Full Amount
or
2. Credit Card: Visa Master Card
Card Number Exp. Date (mm/yy) /
Name as it appears on Card:

Signature as it appears on Card: ______________________________

YOUR ORDER
If you need more item lines, please attach a sheet with the correct information for each item.
Item# Description / Color Qty. Price Each Total
________ ___________________________________ ________ ___________ ___________
________ ___________________________________ ________ ___________ ___________
________ ___________________________________ ________ ___________ ___________
________ ___________________________________ ________ ___________ ___________
________ ___________________________________ ________ ___________ ___________
________ ___________________________________ ________ ___________ ___________
Sub-Total: Merchandise ___________
Orders in PA, Add 6% Sales Tax
___________
Shipping & Handling ___________
Canada & Overseas Shipping & Handling ___________
Order Total ___________

SHIPPING & HANDLING INFORMATION
If your total order is:

$00.00 - 25.00   --- add $7.00   for shipping & handling
$25.01 - 50.00   --- add $9.00   for shipping & handling
$50.01 - 75.00   --- add $10.00 for shipping & handling
$75.01 - 100.00 --- add $11.00 for shipping & handling
Over $100.00    --- add $15.00 for shipping & handling

Special Instructions:



For orders to be shipped outside USA, please specify parcel post or air mail. The appropriate charges will be added. Most shipments within USA are currently sent via USPS Priority Mail. If you need faster service, we can offer FEDEX for an additional fee. Please inquire.

Orders usually go out within a few days, if item is in stock -- unless we are away at a quilt show or in Japan.

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©2003-2006 Quilters' Express to Japan
Susan B. Faeder - PO Box 294, Lewisburg, PA 17837 USA
Phone or fax: 570.522.7480
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