MORGAN'S CANDLES
58 HIGH ST.
MONTROSE, PA 18801

MAIL IN ORDER FORM

Billing Information:

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Billing Address:     ___________________________________

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Phone Number:     ___________________________________

Email Address:      ___________________________________

Shipping Information

___  Check if Shipping Information is the same as Billing Information (otherwise give shipping information below)

Name:                   ___________________________________

Shipping Address:  ___________________________________

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Product Information:

Product # Product Description Scent/Color Qty Price Each Total Price
           
           
           
           
           
           
           
           
           
           
           
Merchandise Total Shipping Charge
$0.01 to $19.99 8.95
$20.00 to $49.99 10.95
$50.00 to $99.99 12.95
$100.01 to $199.99 14.95
$200.00 and up 16.95
Merchandise Total  
Shipping Charge  
PA Residents Please add 6% Sales Tax  
Order Total  

Special Instructions

Method of Payment

___ VISA        ___ M/C    ___ AMEX    ___ DISCOVER
___ CHECK/MONEY ORDER (Please make payable to: Morgan's Candles)

CC#: ___________________________        Exp Date:  ___________    Security Code: ________

Signature: _________________________________        Date: _____________