Eccentric Accents --- Printable Order Form

Item Name

Cost

Qty

Item Total

Subtotal

CT residents add 6% Sales Tax

Shipping and Handling

Subtotal	S/H charge %
$.01 to $4.99	Add 20%
$5.00 to $14.99	Add 17%
$15.00 to $39.99	Add 14%
$40.00 to $99.99	Add 12%
$100.00 and up	Add 8%

Total

Shipping information:
Name:_______________________________________________________
Address:_____________________________________________________
City:_____________________________State:_____ Zip:_______________
Phone:(______)______-___________
eMail:_______________________________________________________

Mail check or money order to:
Eccentric Accents
P.O. Box 183
Bethany, CT 06524