Mostly Glass Order Form

Mostly Glass Order Form
Please provide the following contact information:

Billing Address

Shipping Address

Information must match credit card billing.

Same as billing.

Name (first, last)
Address:
City:
State/Province:	Zip code:
Country:
E-Mail:
Daytime Phone:

Name:
Address: (No PO Box)
City:
State/Province:	Zip code:
Country:
E-Mail:
Daytime Phone:

Item Name / Description	Artist Name	Qty	Unit Price	Total/$

You may choose to submit your credit card information by phone: 888 454 1666

MASTERCARD VISA
Credit Card Number
Expiration Date in the format of - Month (mm) / Year (yy):	/
Issuing Bank Phone # (found on back of card):

ORDERING TERMS AND CONDITIONS:
All orders will be confirmed by e-mail or phone.
The Art Objects are individually made and may vary.
If you are not satisfied with your purchase, returns for refunds may be made within 7 days of receipt.
Returns for store credit or exchange may be made within 30 days of invoice date.

Insurance and Shipping fee is usually 6% of the item price.
Shipping cost is more for delicate and oversized pieces
Exact shipping cost will be given upon the purchase.
New Jersey Residents will be charged the 6% sales tax

Tel 888 454 1666 Fax 201 503 9522
ADDRESS: 34 Hidden Ledge Rd. Englewood, NJ 07631

I have read and agree on the above terms and conditions

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