Random Art Designs
539 Fowler Rd.
Alpharetta, GA 30004

770-682-1027
e-mail:info@randomart.org

Order Form

 Name:_______________________________   E-Mail_________________________ 

Address:_____________________________  Telephone_____________________ 

City:_________________State:____Zip:_______

  ITEM                DESCRIPTION                                                     QTY         PRICE         TOTAL

 Plate 1

 Stamp Plate 1

 

 20.00

 

 Plate 2

 Stamp Plate 2 

 

 20.00

 

 Plate 3

 Stamp Plate 3

 

 20.00

 

 Plate 4

 Stamp Plate 4

 

 20.00

 

 Plate 5

 Stamp Plate 5

 

 20.00

 

 Plate 6

 Stamp Plate 6

 

 20.00

 

 Plate 7

 Stamp Plate 7

 

 20.00

 

Plate 8

Stamp Plate 8

 

 20.00

 

Plate 9

Stamp Plate 9

 

 20.00

 

Plate 10

Stamp Plate 10

 

 20.00

 

Plate 11

Stamp Plate 11

 

 20.00

 

Shrine 1

 Stamp Plate Shrine 1

 

 20.00

 

Wings 1

Wings 1 Stamp Plate

 

 20.00

 

Wings 2

Wings 2 Stamp Plate

 

 20.00

 

Lenses Optical Lenses      2.50  
         

Order 2 or more items and take 10% off

            SHIPPING                                                                                                               

$0 -  40.00

 $4.00

 

SUBTOTAL

 

$40.00-80

 $5.00

 

DISCOUNT

(                    )

Over $80.00

 $6.00

 

SALES TAX (GA 6.0%)

 

 

 

 

SHIPPING

 

   

 

TOTAL

 

Canadian orders add $2.00, Overseas orders add $4.00, Georgia Residents please include tax.
Please mail your check payable in US Funds to the address shown on the top this form.
Make checks payable to: Libby White