DOWNLOAD THIS FORM, FILL IT OUT AND RETURN IT AS AN EMAIL ATTACHMENT OR BY POSTAL MAIL.
Date of order____________________________________
Name:________________________________________________________________________________
Postal Address: ______________________________________________________________________
_______________________________________________________________________________________
Email:_____________________________ Phone number: _______________________________
Where did you hear about the Smart Stand?_________________________________________________
YOUR ORDER:
___ Smart Stand, Canvas Case, and Smart Cart ALL-INCLUSIVE $585 (You save $20)
___ Smart Stand with Canvas Case $410 (you save $10)
___ Basic Smart Stand alone, in walnut or cherry , with your choice of overlay design, or plain: $355
___ Smart Cart alone $185
___ Case alone $65
STAND Wood type: __ cherry __walnut
Stand Overlay Design: __Celtic knot __butterfly __birds __no design
CART wood type: __ cherry __walnut (please be aware that there may be natural variations in wood colors)
SHIPPING, HANDLING AND INSURANCE – US Mail Priority Special Handling:
For the Smart Stand with or without the Case:
__ Western Coastal states $75 (WA, OR, CA, CA) WA State residents add 9% Tax
__Rocky Mt. states $99 (MT, ID, WY, NV, UT, CO, NM, AZ)
__Midwest States $115 (ND, SD, NB, KS, OK, TX, MN, WI, IA, IL, MS, AR, LA)
__Eastern states $125 (ME, NH, VT, MA, CT, RI, NY, PA, OH, IN, KY, WV, VA, NJ, DE, MD, DC, NC, TN, SC, GA, AL, MS, FL))
__Eastern Canada $90 __Western Canada$79 __Australia$125 __Europe$140
The Smart Cart is shipped separately by US Mail Priority Special Handling:
___ West Coast$49 __ Mountain States $75 ___ Midwest States $85 __Eastern States $99 ___ Australia $86
___Eastern Canada $75 __ Western Canada $85
____________________________________________________________________________________________________
TOTAL DUE: $______________________________
PAYMENT METHOD:
__ PayPal (preferred): an invoice will be sent to you at the email address you provide above.
__ Credit card: Please provide your card number, expiration date, CVV number and zip code.
__ Check: all checks MUST be in US funds. Make your check to: Laurie Riley, PO Box 1748, Port Townsend WA 98368
Questions? Email laurie@laurieriley.com
