Something Familiar - Order Form Total Price CUSTOMER INFORMATION No refunds made. Make sure
you double check the spelling of your names.
Complete your order and send with credit card info, check or money order
(USD ONLY)
made payable to:
Linda Chavira
416 Emerald Trail Way
El Paso TX 79928
915-276-1040
lchavira@elp.rr.com
Please fill out a separate order
form for each plaque ordered
# of Face
(see samples)
Gender
Hair Style
Relation
Pet Color
Saying on Plaque-
Flower color-Total # of faces =
4--$15.00
10--$23.00
11--$24.00
13--$26.00
14--$27.00
15--$28.00
TX Residents add 8.25% tax -
$5.50 per orderShipping & Handling
TOTAL ORDER
CREDIT CARD INFORMATION
Name on Card -
Card Number -
Exp.date
Circle One: VISA M/C
Customer Name
Address
City State Zip Code
Home Phone# Work Phone# Email Address
Any changes on faces can be made when the "proof" is emailed for approval.
Upon approval plaque is completed and mailed. No changes or corrections can
be made after.