FAX / MAIL ORDER FORM

Wyndham Needleworks
P.O. Box 248, Eastford, CT USA 06242
Email: Lydia@WyndhamNeedleworks.com
FAX: 860-974-1215

Description
Designer/Chart Name or Product Description

Quantity

Price

Amount

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We charge only the actual shipping cost of your order, which is determined at the time your parcel is sent.  Actual shipping charges will be added to the total.

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Total

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Name: ______________________________________________________________________
Address: ______________________________________________________________________
  ______________________________________________________________________
City/State/Zip: ______________________________________________________________________
   E-mail: ______________________________________________________________________
Phone: __________________      FAX:  __________________                                                 

                           ( ) Visa      ( ) MasterCard      ( ) Discover
Number _______________________________________________ Exp. Date _____________
Signature ______________________________________________ Verification Code _______
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