Order Form

Please print this order form to fill out and mail with payment to:
Lori Madison
Amelia Crafters
16601 Genito Road
Amelia, VA 23002

Name: _______________________________________________________________

Address: ______________________________________________________________

City: _____________________________State: ______________Zip:______________

Phone: ________________________ Email Address: __________________________

Qty. Product Description Price Ea. Total Price
______ ____________________________________ $ $
______ ____________________________________ $ $
______ ____________________________________ $ $
______ ____________________________________ $ $
______ ____________________________________ $ $
______ ____________________________________ $ $
______ ____________________________________ $ $
______ ____________________________________ $ $
______ ____________________________________ $ $
______ ____________________________________ $ $
Subtotal $ $
Add VA 5% sales tax for shipments in VA $ $
Add $8.95 shipping charge $ 8.95 $ 8.95
Total Due $ $
Thank you for your order.


Copyright © 2005 Amelia Crafters. All Rights Reserved.