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MILLER DESIGNS
GAIL BARKER MILLER
36 Fenderson Rd ~ Chebeague Island, ME  04017
Tel. (207) 846-4369 ~ Fax (207) 846-4369
    ORDER FORM
Name _____________________________ Date Ordered________________________
Address ___________________________ Contact Person ______________________
__________________________________ P.O.# _____________________________
Phone/Fax _________________________ Terms _____________________________

ITEM # DESCRIPTION
METAL
QTY
PRICE
TOTAL
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.. .. .. .. .. ..
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.. .. .. .. .. ..
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*
Total of all items listed above.
*
*
SUBTOTAL
.
*
Multiply SUBTOTAL by .05 to get MAINE TAX (if applicable).
*
*
MAINE TAX
.
*
See Shipping Rates Below.
*
*
SHIPPING
.
*
Special Shipping Outside US. (Call)
*
*
OTHER
.
*
Add SUBTOTAL, MAINE TAX, Shipping Rates & Special Shipping Rates
*
*
GRAND
TOTAL
.
All shipments outside the U.S. will be billed a $2.00 handling charge and exact shipping costs. 
All amounts are for USD (United States Dollars).
Maine Residents add 5% Sales Tax.
Shipping Rates:
One (1) to three (3) items - $1.50 ($4.00 for USPS Priority Mail)
Four (4) to ten (10) items - $4.00
Eleven (11) to twenty (20) items - $6.00
Twenty-one (21) items or more - Call for special rates

Method of payment:
Check _____  Visa _____   Mastercard _____
Credit Card #:________________________
Expiration Date: Month ____________   Year __________
Name on Card __________________________________