Order Form

To place an order, highlight the form below with your mouse, copy it, and paste it into an email to michelleferretti@entermail.net and then fill out the required info and send.

Put an "X" in front of items you are ordering.   When ordering a lamp the shade is included.
      Lamp & Shade           Shade Only

Pricing:   A 50% deposit is required at time of order.   Balance will be due before the item is shipped.   (You will be contacted when the item is ready to ship)

Description	Price Range (Quote made before order is final)
Lamp & Shade	$75 And Up
Shade Only	$25 And Up
Shipping Costs (UPS Ground)	Variable

Order Information
Purchasers Name:
Bill To Address:

Phone:
Ship to address:

Payment Method (Put an "X" before method)
Visa         Mastercard         Money Order         (Please do not send cash or checks)
Card Number:
Expiration Date:
Name on Card:
Total (Item Cost + Shipping Cost):

Design
Please choose a theme, color scheme, and any specific ideas you would like included in the design of your lamp and shade.   Please be as specific as possible. I will do my best to include your ideas.

Theme:
Color Scheme:
Specific Ideas: