Em-Li's
Order Form
Carol Sessoms
The Linen Sampler
4020 South Cove Lane
Belmont, NC 28012
Phone: 704-825-1807
Please print
and fill out, then mail to the above address
Sold
To
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Date |
Mailing Address
|
Method of Payment
[ ] Check or Money
Order
[
] Mastercard
[
] Visa |
| Signature of Credit
Card Holder |
Credit Card Account Number
__|__|__|__ - __|__|__|__
- __|__|__|__ - __|__|__|__
Expiration Date
|__|__| - |__|__| |
| Quantity |
Name of Chart/Name of
Designer |
Price Each |
Amount |
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Postage: we will charge only what it costs us |
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NC Residents Add 6% |
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Total |
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