Pat's Web Graphics Order Form

Pat's Web Graphics

Graphics CD Order Form

Fill out this page on your computer then choose your browser's Print Page option from the file menu to print this form.

Mail completed order form with check, money order or payment instructions to:
Pat's Web Graphics
2221 White Oak Rd.
Derby, KS 67037

Item	Quantity	Cost Each	Total

7th Anniversary Graphics CD 6.0		$50.00
Flowers by Pat 6.0		$35.00
Roses by Pat 3.0		$17.50
Tea Time with Pat 2.0		$17.50
Quilt Graphics 3.0		$15.00



All orders are shipped via US Postal Service
Ground - 4 to 7 days		$3.00
Priority Shipping - 2 to 3 days		$6.00
Global Priority (outside US) where available		$12.00
	Total
I am making payment by check or money order, enclosed:

Charge it to the following credit card: Visa, MasterCard, American Express & Discover accepted.

Credit card number: Expiration date:

Please enter your credit card number & expiration carefully, if it is incorrect, your request cannot be processed.

Would you like your order shipped to address above? If not fill in an alternate address below.

NAME:_________________________________

ADDRESS:_____________________________

City:___________________________________

State:_______________ ZIPCODE___________

Thank you for your order! Please allow up to 2 weeks for regular delivery.