Name of item






Color






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L






XL






XXL






Qty.






Price







Name
Address
City, State, ZIP

E-Mail Address
Phone Number
Order Subtotal
Shipping
Order Total
Amount Enclosed



TO ORDER, you can:

  • Fill out the form above, hit SUBMIT, and we'll call you back for billing info, or
  • E-mail the above information to giftshop@widmer.com, or
  • Print out this page, fill it out and fax it to 1-800-SAY-HAYFA (800-729-4293), or
  • Mail it to:
    Oregon Screen Impressions, Inc.
    
    1215 S.E. 8th Ave.
    
    Portland, Oregon 97214
  • If you fax or mail us the form, you can include your billing info (credit card number, expiration date, etc.)
    Sorry, we are unable to ship internationally.