Order Form

Name ___________________________________________________ Date ____________

Street Address _____________________________________________________________

City _____________________________ State/Province ______________ ZIP __________

Country _____________________ E-mail address _________________________________

Home phone ________________ Bus. phone ________________ FAX ________________

Code Description Color Size Quant. Unit cost TOTAL
             
             
             
             
             
             

Subtotal --- (free gift for subtotal of $20 or greater - see below) 		$
6% sales tax --- (Maryland residents only) $
Shipping & handling (see below) $
GRAND TOTAL $

Free gift

Subtotal = $20-$50, 1 bumper sticker

(check 1) ___ piano, ___ Slovenian, ___ Cajun

Subtotal more than $50 - ___ $5 gift certificate
Shipping & handling (US)

___ Subtotal up to $20 - $4.50
___ Subtotal $20-$40 - $5.50
___ Subtotal $40-$65 - $6.50
___ Subtotal over $65 - 10% of subtotal

Shipping & handling (foreign) - please inquire

Send your order to --- SqueezinArt, PO Box 2001, Rockville, MD 20847, USA
FAX your order to --- 301-279-7331
PHONE your order to --- 301-279-8716      Email inquiries to: squeezinart@comcast.net

We accept check, money order, or credit card <VISA, MC> (outside US credit card only) -- NO CASH!
For credit card, please provide the last 3 digits located on the back of the card on the signature line
|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| |__|__|/ |__|__| |__|__|__|
Card # Exp (month/year) 3-digit code

cardholder's signature __________________________________________________