| Mail Form To: |
Contois Reynolds Glass Studio 1501 Trace Creek Road, Hamlin, WV 25523 Phone: (304) 824-5651 or (800) 218-6185 |
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| Item Name or Number | Quantity | Price Each | Shipping | Total |
| Date of Order: | Total Due $ | |||
| Payment by: Visa, MasterCard, Check or Money Order | |||
| Credit Card # | Exp. Date: | ||
| Signature | |||
Check here [ ] if you wish item to be shipped to address other than indicated above ... please write desired shipping address on back of form. Thank you for your order ... Enjoy!
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