| HENDERSON'S
REDWARE |
||
| 53
DOWNING ROAD |
(207)
942-9013 |
fax:
(207) 942-9044 |
| BANGOR,
MAINE 04401 |
Toll
Free : 866-376-4475 |
|
| Retail
Order Form |
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| (Print
this page from your web browser and fill it out; then mail, fax, or
call in your order.) |
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| PURCHASER: | TELEPHONE #: |
| E-Mail: |
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| BILLING ADDRESS: | SHIPPING ADDRESS (if different): |
| Date
of Order: |
Please
allow 1-3 weeks for delivery |
Date
Shipped: |
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| ___________ |
___________ |
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| Method
of Payment |
Check
enclosed |
Mastercard |
VISA |
Expiration
date: |
V-Code: |
| (check
one): |
.
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.
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| Credit
Card Number: |
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| Quantity |
Item
Number |
Item
Name and Description (size, style, decoration, etc.) |
Unit
Cost |
Extended
Cost |
| . |
. |
. |
$ |
$ |
| . |
. |
. |
$ |
$ |
| . |
. |
. |
$ |
$ |
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. |
$ |
$ |
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$ |
$ |
| . |
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. |
$ |
$ |
| . |
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. |
$ |
$ |
| |
SUBTOTAL |
$ |
$ |
|
| Shipping
/ Handling by zone, see chart |
$ |
$ |
||
| ME
residents only: add 5% sales tax |
$ |
$ |
||
| TOTAL |
$ |
$ |
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