2157 Madison 5430 (formerly HC 61, Box 335), Elkins, AR 72727
(479) 643-3658           willowmoon@ziplip.com

  Please print out this order form
and mail it with your check, money order or bankcard number,
or use it as a checklist to phone in your orderphone in your order.
  To order On-Line, Click HERE

Ordered by:	Send to:
Name _______________________________	Name ________________________________
Address _____________________________	Address ______________________________
City ________________________________	City _________________________________
Phone ______________________________	Phone _______________________________
Email ______________________________	Email ________________________________

Quantity	Size	Design	Color	Style	Price each	Total
Total for merchandise
AR residents add sales tax
Shipping and handling: under $40 add $3.95; $40 to $60 add $5.20; over $60 add $6.45
Garments are hand-dyed. Wash in cold water separately or with darks the first two washings.					Total

Checks, Postal Money Orders, MasterCard, Visa, and Discover Cards are welcome.
If paying by check or money order, please put the number here:_ _ _ _ _ _ _ _ _

Your Bankcard number: _ _ _ _  _ _ _ _  _ _ _ _  _ _ _ _   exp: _ _ /_ _

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