Name of item
Color
M
L
XL
XXL
Qty.
Price
Name
Address
City, State, ZIP
E-Mail Address
Phone Number
Order Subtotal
Shipping
Select One
$12-$24 add $3.75
$25-$49 add $5.50
$50-$99 add $6.75
$100 and up add $7.50
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.
