PRINT AND MAIL FORM

Print out order blank, complete form, and mail to:

Early Times Workshop
1208 Oaklawn Drive,
Culpeper, VA 22701

Fax or phone in completed order to: 540-829-7200

Name:	Date:
Street Address:	Phone:
City & State:	Zip:

Item#

Name

Quantity

Item Price

Extension

Shipping & handling:

$ .00 to $10.00 - $1.00
$10.01 to $20.00 - add $2.00
$20.01 to $30.00 - add $3.00
$30.01 to $40.00 - add $4.00
$40.01 to $50.00 - add $5.00
$50.01 to $60.00 - add $6.00
$60.01 to $70.00 - add $7.00
$70.01 to $80.00 - add $8.00
$80.01 to $90.00 - add $9.00
$90 and above - add $10.00

Make checks payable to:
Early Times Workshop

For credit card payment:
Circle One:
Visa --- Master Card --- Discover

Account Number:

Expiration Date:

CCV number (security number on back of card):

Signature:

Sub Total

Virginia residents add 5% sales tax.

PRINT AND MAIL FORM

Item#

Name

Quantity

Item Price

Extension

Shipping & handling:

Account Number:

Expiration Date:

CCV number (security number on back of card):

Signature:

Sub Total

Sales Tax

See chart to determine correct shipping

Shipping

All International orders, send e-mail for shipping rate

Total Due

THANK YOU!