Healthy Handmade Shoes Order Form
 

Return to: Healthy Handmade Shoes, 109 Broad Wing Trail, Lexington, VA 24450
Item Description	Qty	Price	Total
Baby Booties - 1 to 2 months (specify number of each color)                                                                                   ___ natural    + ___ white =		x $20.00	=
Baby Booties - 3 to 5 months (specify number of each color)                                                                                   ___ natural    + ___ white =		x $20.00	=
Amish Kids' Shoes, Sizes 1 - 6 (specify number of each size and color)   Black:  ___ 1     + ___ 2     + ___ 3     + ___ 4     + ___ 5     + ___ 6 +         Brown:  ___ 1     + ___ 2     + ___ 3     + ___ 4     + ___ 5     + ___ 6 =		x $40.00	=
Amish Kids' Shoes, Sizes 7 - 8 (specify number of each size and color)                                                                                 Black:  ___ 7    + ___ 8 +                                                                                         Brown:   ___ 7    + ___ 8 =		x $45.00	=
Amish Kids' Shoes - Custom Orders (In the blanks below, indicate size and color desired. If a heel is desired, specify "wedge" or "stock". To the usual price for a pair of the size you order, add $5 for a custom color, $5 for heels. To order additional custom shoes, use the back of this form to list them, and put the total price here. Made-to-order shoes will take longer.) Size ___      Color ___________________      Heel ______________			=
Subtotal
Virginia residents add 4.5% salestax
Shipping and handling (see chart below)
Total Due (Make check or money order payable to Glen Leasure)
Your name, phone # and address:

Shipping and Handling Charges:

Orders of:	$0 - $25.00	$25.01 - $50.00	$50.01 - $100.00	$100.01 and over
S & H =	$2.00	$4.00	$6.00	$7.00