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ORDER FORM

Please print this form and mail to illusion with check or credit card info.
If purchasing with credit card you could FAX your order to 716-271-1251


Name:

Address:

City:

 

State:

 

Zip:

 

Phone:

 

E-mail:

 

____ Yes!

Please call me to discuss my order. Call me: ___days  ___evenings

QTY

Item #

Description (color, size, etc.)

Price

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Make check payable to illusion

Mail to:
illusion
7 Faraday Street
Prescott, AZ 14610

Subtotal:

 

Sales Tax:
NY residents add sales tax

 

Shipping & Handling:

$5.00

Total:

 

   Yes! I'd like to pay for my order by:
   ____
Visa  ____ Mastercard  ____Discover ____ American Express (Please check one)

Credit Card #

Exp. Date

Card Member Signature

 

 

 


Please allow 2-4 weeks for delivery.      Check here for time sensitive orders____



necklaces| bracelets | watches | pins | pendants | earrings | beads | partners | drawer pulls | tiles | buttons

for more information 
please e-mail us!
928-445-5571
ILLUSION
Prescott, AZ


www.illusionglassworks.com