Scrapbook Apparel Mail Order Form




Name:_____________________________________________________________


Company Name(If Applicable):______________________________________


Street Address:___________________________________________________


City:_____________________________ State:________ Zip:____________


Day Phone:______-______-____________


Eve Phone:______-______-____________


E-Mail:_____________________________


Item:_____________________________________ Qty:______ Price:___________


Item:_____________________________________ Qty:______ Price:___________


Item:_____________________________________ Qty:______ Price:___________


Item:_____________________________________ Qty:______ Price:___________


Item:_____________________________________ Qty:______ Price:___________


Item:_____________________________________ Qty:______ Price:___________

                                     
                                      
                                        Sub Total:_____________________


			Shipping(See Chart Below):______________________


	      Ia Residents add 7% State/Local Tax:______________________


					    Total:______________________



Shipping Chart:
  .01 - $10.00: 2.50
10.01 - $49.99: 4.25
50.00 - $99.99: 8.00
100.00-$199.00: 10.00
  Over $200.00: 12.00



Payment Accepted: Check, Money Order, or Cashiers Check.
Please Remit To:

Scrapbook Apparel
720 So. Linn St.
Sioux City, Ia.  51106


Thanks for your order!