Designs By Phyllis Stafford

Order Form

For mail in orders please print this form and mail with payment to the address bellow.

Customer:                                                                  Ship to: (If different from customer address)

Name:___________________________                        Name:___________________________

Address:_________________________                        Address:_________________________

________________________________                         ________________________________

City:____________________________                         ________________________________
State:_______________Zip_________                          State:_______________Zip_________

Telephone:_______________________                        Telephone:_______________________

E-mail(optional)____________________________

Mail Order Form with check or money order made payable to:

                                                                                          Phyllis B. Stafford

                                                                        90 Brandywine Lane

                                                                        Suffield, Ct    06078

Please remit funds in US dollars

Allow 1-2 weeks for delivery