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: $________________

 Return to: Product Page
*     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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