Order Form
Glassy Lady
8818 Wyoming Street ~ Omaha, NE 68122
You may order using any of the following methods:
- using the "Buy Now" buttons and entering your credit card information in our secure shopping cart
- filling out this form online, printing, and mailing with a check or money order
- printing the blank form, filling it out by hand, and mailing with a check or money order
BUYER'S ADDRESS
| Name |
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| Street Address |
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| City |
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| State/Zip |
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| email/phone |
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SHIPPING ADDRESS (if different than buyer's address)
| Name |
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| Street Address |
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| City |
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| State/Zip |
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| Qty |
Item Name
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Item Number
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Price Each
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SHIPPING
(International orders - please e-mail
for shipping details)
All domestic orders shipped flat rate $7.95
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Nebraska residents add 7%
sales tax
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| TOTAL ORDER |
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Entire contents © Copyright
1998-2012 by Glassy Lady
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