Click for Blank Order Form (Adobe PDF format)

Please use the above link to print a blank PDF order form. Fill out the form and enclose a personal check, money order, or enter your credit card information in the indicated areas. Please do not forget to sign the form for credit card approval.

SHIP TO:
Name:
Address:
Box #:
City:
State: Zip:
Date:
Email:


ORDER FORM

Quantity Item Design Price Total
Baby Bootie pink rose/blue rose (include info) $24.95
Baptismal Cross pink rose/blue rose (include info) $24.95
Bisque Egg tame rose/wild rose/pansy/lilac $44.95
Ball Ornament wild rose/winter scene $19.95
Ornament Stand For display $3.00
Lefse Sugar Shaker wild rose/pansy/lilac $22.50
Lutefisk Butter Pitcher wild rose/pansy/lilac $22.50
Matching Lefse Tray wild rose/pansy/lilac $39.95
Lefse 3 pc. Set (save $5 on set) wild rose/pansy/lilac $79.95
Wild Rose Cards 8 pack $6.95

Quantity Art Supplies and/or Studies Price Total

PAYMENT METHOD
Date:
Check or Money Order $:
MasterCard Check Other
Visa Money Order PayPal
Complete Credit Card No.:

Expiration Date:

3 digit security No. on the back of card:


__________________________________
Customer Signature
Shipping & Handling
for Porcelain Items:
Up to $24.99   30%
$25.00 - $49.99   25%
$50.00 & up   20%

Shipping & Handling
for Supplies Only:
First Class: 1-13 oz: $5.40
Flat Rate Small Box: $7.90
Flat Rate Medium Box: $14.35
Flat Rate Large Box: $19.95
Flat Rate Padded Envelope: $7.50
Subtotal
Sales Tax 7%
(ND residents only)
Shipping & Handling
TOTAL:
ALLOW 4-6 WEEKS FOR DELIVERY

MAIL OR FAX TO:
Vida Klocke    706 Grant Place    Underwood, ND 58576
701-442-3478 (phone/fax)
e-mail vidaklocke@gmail.com