Order By Mail

Mail order form to:

Ship To: Name: Address: City:                             State:               Zip:

Please provide a daytime phone number in case we have any questions about your order. phone (     ) e-mail address

Karen A. Einsel www.myuniquebaskets.com 9481 Sierra Ave Fontana, CA 92335 Ph. (909) 854-0422

Allow 1-2 weeks for delivery Make checks payable to; Karen Einsel

Total for items S&H Total enclosed

Method of payment Check Money order note; credit or debit orders must be placed on line.

Shipping  and handling charges $6.00          $0.01     to       $12.99 USD $9.00          $13.00   to       $25.99 USD $12.00        $26.00   to       $39.99 USD $15.00        $40.00   to       $59.99 USD $18.00        $60.00   to       $75.99 USD *call or e-mail for shipping costs on orders over $75.00

* Free gift with every order!

ITEM DESCRIPTION                                                                 QTY.           PRICE           TOTAL            NOTES