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Order Form |
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We accept check or money orders. Simply print out this
page and fill it in. Send the completed form with enclosed payment to:
Herk'sWorks
Orders paid by check will be shipped upon the check clearing.
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| Name: | ______________________________ | |||
| Address: | ______________________________ | |||
| ______________________________ | ||||
| ______________________________ | ||||
| Phone: | ______________________________ | |||
| Email: | ______________________________ | |||
| Mason Mug | Angled Cylinder | Rounded Cylinder | Spherical Mug | Original Rounded Jar | FaceMug | |
| Qty. | Qty. | Qty. | Qty. | Qty. | Write ID#'s of Facemugs below | |
| Southwest | _____ | _____ | _____ | _____ | _____ | |
| Rainforest | _____ | _____ | _____ | _____ | _____ | |
| Original | _____ | _____ | _____ | _____ | _____ | |
| The Blues | _____ | _____ | _____ | _____ | _____ | |
| TOTAL QUANTITY | _____ | _____ | _____ | _____ | _____ | |
| Mugs- $16.00
Jars - $14.00 FaceMugs - $40.00 |
$_________ | $_________ | $_________ | $_________ | $__________ | SUBTOTAL $_________ |
| Shipping:
Order one item, add $7.00 Order two items, add $9.00 Order three items, add $12.00 Pennsylvania residents, add 7 percent sales tax |
TOTAL
$_________ |
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| Payment Information
Please make checks or money orders payable to "Keith Herchenroether". |
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| Payment Type: (circle)
Check Money Order
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