Dancing Flowers Print Order Form

Name:_________________________________________________

Address:_______________________________________________

City, State, Zip:_________________________________________

Day Phone:___________________Evening:___________________

Email:_________________________________________________

Ship To:

Name:_________________________________________________

Address:_______________________________________________

City,State,Zip:__________________________________________

Phone:________________________________________________

	Merchandise Total.......................	$__________
	9% Sales Tax if shipped within Illinois................	$__________
	Shipping and Handling (see ordering page).......................	$__________
	Total................................	$__________

Please enclose check or money order payable to Dancing Flowers or Judith Seeger and postal mail to 1740 N. Clark St., Unit 1726, Chicago, IL 60614