|
Mail Form To: |
Contois Reynolds Stained Glass Magic Studio
1501 Trace Creek Road, Hamlin, WV 25523 Phone: 304.824.5651 http://www.contemporarymirrors.com |
| Name | |||
| Address | |||
| City | |||
| State | ZIP | ||
| Phone | |||
| Item Name or Number | Color | Price Each | Quantity | Total |
| Add Shipping: Sm Mirrors ~ $20 ; Midsize ~ $25 ; Lg ~ $40 | Shipping $ | |||
| Date of Order: | Total Due $ | |||
| Please make checks or money orders payable to CONTOIS REYNOLDS | |||
| Charge cards accepted: Visa, MasterCard, Discover, American Express | |||
| Credit Card # | Exp. Date: | ||
| Signature | |||
- We ship nationwide!
- [ ] Check here if you wish item to be shipped to address other than indicated above ... please write person's name and their shipping address on back of this form.
- THANK YOU FOR YOUR ORDER!
Back to: Home Page