Name:____________________________ E-mail:______________________  

Phone:_______________  Address:_________________________________  

City:________________________  State:___________   Zip_____________   

 

Item # Title Price Amount Total Price
         
         
         
         
         
         
         

SubTotal :________

Shipping (see chart below):________

Total:_______
Shipping Charges
$5.00 $19.99 or less total
$8.00 $20.00-49.99
$12.00 $50.00-99.99
$18.00 $100.00-199.99
$30.00 $200.00-and up
 
Please make check to Living Arts Originals.