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starrylights.com
Mail-in Order Page
| Orders will be shipped when Check clears. | Mail completed form and payment to: Starrylights, Inc. Beth Berggren 1321West 82nd Street Minneapolis MN 55420 |
Please print this page and fill in the following information:
Special request? Contact the artist at studio@starrylights.com.
| Qty | Item | Subtotal | ||
| ( ) | Dragonflies @ $35.00 each | $ ________ | ||
| ( ) | Fireflies @ $35.00 each | $ ________ | ||
| ( ) | Bees @ $35.00 each | $ ________ | ||
| ( ) | Summer @ $35.00 each | $ ________ | ||
| ( ) | Hot Heart @ $35.00 each | $ ________ | ||
| ( ) | Houses @ $35.00 each | $ ________ | ||
| ( ) | Other | |||
| ( ) | Other | |||
| FREE SHIPPING to U.S.** | ||||
|
Total Amount |
$ ________ |
Payment by Check ( ) Credit Card ( )
Make checks payable to Starrylights, Inc.
| Purchaser: Name: _____________________________________________________ Address: _____________________________________________________ Address #2: _____________________________________________________ City: _____________________________________________________ State/Province: _____________________________________________________ Zip/Postal Code: _____________________________________________________ Country: _____________________________________________________ Telephone Number (required): _____________________________________ E-mail Address: ________________________________________________ |
Shipping Address (if different
from Purchaser): Recipient: ______________________________________________________________ Address: ______________________________________________________________ Address #2: ______________________________________________________________ City: ______________________________________________________________ State/Province: ______________________________________________________________ Zip/Postal Code: ______________________________________________________________ Country: ______________________________________________________________ |
Type of Credit Card: Visa ( )
MasterCard ( )
Credit Card Number*: ___________________________________________
Expiration Date*: _______________________________________________
Name and billing address of card holder if different from Purchaser shown above
(required):
*If you would prefer that we call you for your Credit Card information, leave
these areas blank. We will call to verify your Credit Card information.
**Ordering internationally?
Send us an e-mail and we will
respond with total including international shipping costs.