Check one of the boxes and fill in the needed information.

Describe your request or idea you want to explore or inquire about -- describe here what you have in mind.

Date when you will need this item:

Name and Contact information

Name

Mailing Address

City, State, Zip

Home Phone, and/or

Work Phone

Email Address

Payment Information

Please select from the following options how you plan to make payment.

We will contact you via email or phone to verify your order and answer any questions you have. We can then discuss a final order and payment method.

PAY BY PAYPAL - No PayPal account necessary for credit card payments. We will email an invoice for the total amount including the shipping costs. (If you are not familiar with PayPal, click icon to learn more)

PAY BY CHECK - We will email an invoice for the total amount including the shipping costs.

Click to view my before sending order.

Print this form for your records before submitting. Thank you.

Created by Roy Yoder, Oakleaf Pottery