Order Form
Rosemarie N. Rush
5428 Walnut Lane, Yorba Linda, CA 92886
Phone/Fax (714) 701-9262
hoofedimages@aol.com - http://www.rosemarierush.com/
Name
Address
City
State
Zip
Phone
email

DESCRIPTION
SIZE PRICE
EACH
QTY
SUB
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SHIPPING & HANDLING
Purchase oft $3 - $21 $4.50
Purchase of $22 - $35 $5.60
Purchase of $36 - $70 $6.75
Purchase of $71- $90 $8.00
Purchase of $91 - $120 $9.50
Purchase of $121 - $160 $10.00
Purchase of $161 and up FREE
Total:

CA Res 7.75%:

Shipping:

Total Due:


Allow 7 days for delivery.
Check and Money Orders Payable to "HOOFED IMAGES'
American Express accepted
American Express
Card No.
Exp. Date
Name on Card (print)
Signature