Copper Creations Order Form

Order Form

Date:

To order by Credit Card:      Fax or Mail To: To order by Personal Check:      Mail order to:

Copper Creations Copper Creations

757   787-3797 PO Box 150

Inquiries:    copper@visi.net Melfa, Virginia   23410

If Ship to address is different than mail to address list at bottom of this order form.

List Name:

Address:

City:

Zip Code:

E-mail:

Credit Card #:

Expiration Date:
                                       Type of Card: (Visa) (Mastercard)

Telephone #:

Total Amount $
Accepts personal checks & cashier's checks.

Virginia residents: Add 4.5% Sales Tax
Item will be shipped direct from Copper Creations
PO Box 150, Melfa, Virginia 23410
757 787-3797

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Quantity       Product       Description                                                            Amount           Total Due
                    Code

                   ER-01       *Hand Painted Wind Chime:                Large            $ 25.00

                   ER-02         Hand-Crafted Copper Butterfly          Large            $ 10.00

                   ER-03         Hand-Crafted Copper Butterfly          Small            $   7.00

                   ER-04         Praying Manits 28"                            Large            $ 56.00

                   ER-05         Praying Mantis 18"                            Medium        $ 36.00

                   ER-06         Praying Mantis   12"                           Small            $ 12.00

                   ER-07     **Electric Water Fountain Inside                                $150.00

                   ER-08         Electric Water Fountain Outdoors      Call or e-mail for pricing

                                                                         Sub Total: $________________
                Virginia Residents: Add 4.5% Sales Tax: $________________
                                                                   ***Shipping:$ ________________
                                                          Total Amount Due: $________________

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*     Chimes are individually hand-painted on one side with wildlife and a flower on the other 10" in size.
**   Photo Unavailable 20" high - 20" Base diameter.
***   Standard Domestic UPS Rate Applies PAYING BY CHECK: Upon completing your order
E-mail us this page and we will send your shipping charge or e-mail us a total of each quantity and
product code # and we will send you the shipping charge; CREDIT CARD PAYMENT:
Shipping will be adding to order.

If ship to address is different from above: List here (No Post Office Box #'s)
Ship To:__________________________________________________________________________
Address:     ____________________________________________________________________________
City & Zip Code _______________________________________________________________

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To order by Credit Card: Fax or Mail To:	To order by Personal Check: Mail order to:
Copper Creations	Copper Creations
757 787-3797	PO Box 150
Inquiries: copper@visi.net	Melfa, Virginia 23410