2011 New Customer Form 727 se morrison street portland, oregon 97214 tele. 503/709-5479
Date Contact Name
www.pigeontoeceramics.com | hello@pigeontoeceramics.com
P O #
Business Name
Ship to Address
Bill to Address
Residential Delivery Yes No Terms
Credit Card
Telephone
Card Type
No.
Resale License #
Requested Ship Date* Ship Via
Visa
Paypal
MC
UPS
Check
AMEX
Discover
Exp.
USPS
CVV2
Studio Pickup
*Minimum 5 weeks from order date
Ceramics order minimum is $300. Minimum quantity per design is 2. A confirmation invoice with shipping charges and payment information will be sent within 36 hours of order submission. Please submit order via email (we do not have a fax). Order form is not required after opening order.
SKU
QTY ITEM NAME / DESCRIPTION
VARIABLES [glaze / leather]
UNIT $
Order Total
TOTAL $