Retailers Earrings Order Form

home retailers & stores

QUEEN ANGEL EARRINGS ORDER FORM

Retailers Only -To place an order:
US MAIL, PHONE: 828-779-1569, FAX: 828-628-3378 or EMAIL
Terms: Net 30 Days Shipping: Fed Ex Ground

Or Pay Now By: Credit Card or Check (Make payable to Lee Pantas)
Mail To: Lee James Pantas, Cherry Orchard Studio,
18 Garren Mountain Lane, Fairview, NC 28730

Visa/MasterCard American Express

Exp. Date _________ Zip Code Associated With Credit Card_________

Name of Cardholder: __________________________________________

	Billing Address	Ship To: (If different than billing)
Date:		//////////////////////////////////////////////////////////////////////////////
Store/Company NAME:
Address:
"
"
City/State/Zip:
Contact:		///////////////////////////////////////////////////////////////////////////////
Phone:		///////////////////////////////////////////////////////////////////////////////
Email:		///////////////////////////////////////////////////////////////////////////////

Item #	Item	# Of Pairs
LR1-ER/Gold	Gold Cloisonné Queen Angel Earrings
LR2-ER/Silver	Silver Cloisonné Queen Angel Earrings
	SUB TOTAL (5-10 Pairs)		x	$8.50	=
	SUB TOTAL (11+ Pairs)		x	$7.50	=
	MINIMUM ORDER 5 PAIRS: MIX OR MATCH				Add	$ 5.00 Shipping
					TOTAL DUE