| earthly pursuits Revolving Bookcase Order Form | |
| Bill TO | Ship TO (if
different from Billing) We cannot deliver to a PO Box. |
| Name:__________________________________________________ | ____________________________________________ |
| Address1:_______________________________________________ | ____________________________________________ |
| Address2:_______________________________________________ | ____________________________________________ |
| City:____________________________________________________ | ____________________________________________ |
| State/Province:___________________________________________ | ____________________________________________ |
| Zip/Postal Code:__________________________________________ | ____________________________________________ |
| Country:_________________________________________________ | ____________________________________________ |
| Is the ship to address a residence_____ | |
| Telephone:_______________________________________ | or a business_____ ? |
| Fax:____________________________________________ | |
| e-mail:__________________________________________ | |
| Check, Money Order or Credit Card payment. | |
| Tower | Plant Stand | Table | extra Shelves | |
| Please write in quantity | ||||
| Oak & Maple | Oak & Maple | Oak & Maple | ||
| $1,548.00 | $1,090.00 | $902.00 | $17.00 | |
| clear lacquer natural Oak | _______ | _______ | _______ | _______ |
| clear lacquer natural Maple | _______ | _______ | _______ | _______ |
| Stained Oak | Stained Oak | Stained Oak | ||
|
Write in finish |
$1,720.00 | $981.00 | $812.00 | $19.00 |
| Stain__________________ | _______ | _______ | _______ | _______ |
| Paint__________________ | _______ | _______ | _______ | _______ |
| other__________________ | _______ | _______ | _______ | _______ |
|
Please fill out form completely and mail with payment to: earthly pursuits Sales |
Sub-Total: $_______________ call or email for shipping charges. Freight is charged at cost. No added
fees. If actual cost is less than estimate, you will be refunded the
difference. Total: $_______________ |
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website: www.earthlypursuits.com |
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Thank you!! |
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