COD
Item #
JMCERAMICS ORDER FORM
Quantity
Item description
Price per item
Total
         
         
         
         
         
         
         
         
         
         
         
         
I can take credit card orders over the
phone, through email, or regular mail.
Checks, money orders, cods welcome.
JMceramics
Justin Moeller
P.O. Box 140
Davenport, CA 95017
www.jceramics.com
Orders:
(831) 459-6880
jmceramics@comcast.net
__________________________________________________________________________________________
Ship to:
Name:________________________________

Address:______________________________________

_____________________________________________

Phone:_______________________________
Credit card
Card type:____________________

Card number:_________________________________

Expiration date:__________

Security code:___________

Signature:_________________________________
_____________________________________________________________________________________________
Print this form and send with payment                                                                 
                                                                                Subtotal_______________

                              Shipping(will add after order is weighed) ______________
                                                                                    
                                                                                   Total________________
 
 
CREDIT CARD: V/M/A/D