ORDER FORM

Ordered by: Shipped to (if different from ordered by):

___________________________________ ________________________________

name name

___________________________________ ________________________________

address apt. address apt.

___________________________________ _______________________________

city state zip city state zip

( ) -

phone number

___________________________

email address

Qty	Item	Color/Size	Price	Subtotal
			TOTAL

Will this be a gift (free wrapping)? Message:

Shipping: (Quotes will be given based on address)

UPS __Ground __2^nd Day Air

USPS __First Class Mail ___Priority

*Please allow 2-4 weeks for order to be shipped.

Payment:

___Cash ___Check ___Credit card through Paypal (free service with email address)

Options:

___Payment Plan ___Deposit

Refunds: Items can be returned within 7 business days. Deposits and shipping is nonrefundable.

Contact: Sasha Corrodus-Odom sasha@theimaginecafe.com (703)477-3090