Jeff Gold Graphics / 2181 Walden Hill Road / Danville, Vermont 05828-9811
(802) 684-9728 / Fax (802) 684-9760 / email: jeffgold@sover.net

Please print out this form.
Fill it out and mail with your check or money order (in U.S. funds) payable to Jeff Gold.

 ORDER FORM

Quantity

  Item/Size

 Order#

 Title 

 Cost 

 1

 Blank Notes

N101

 Practice Makes Purr-fect

 $8.00

(fill in form as in sample line above)
         
         
         
         
         
         
         
         
         
         

Not all items are available in all designs. Check to see that the order number matches the type of item you are ordering
(see sample line above).

Please make checks payable to
JEFF GOLD

 Subtotal 

  

  Subtract discount if applicable  

  

  Discounted subtotal  

  

 Vermont orders add 6% tax  

  

(based on Subtotal above)  Shipping & handling  

  

  Amount of check  

  

Please allow 3 weeks for delivery.

Shipping and Handling / U.S.
Canadian orders / additional $4.00
      SHIP TO:

 Amount of Order

Shipping Charge
      Name ___________________________

 Up to $10.00

--

 $6.00
     Address _________________________

$10.01 - $30.00 

--

 $7.00
     City _____________________________

 $30.01 - $50.00 

--

 $8.00
     State ______ Zip __________________

 $50.01 - $70.00 

 --

 $9.00
    Indicate your phone number and email address in

  $70.01 - $100.00 

 --

 $10.00
    case we need to contact you about your order.

    Over $100.00  / add 10% of SUBTOTAL
    Phone____________________________
    email ____________________________

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