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Washi Accents Order Form
1224 Converse Dr, Atlanta, GA 30324 TEL. 800-535-2263 404-233-1846 FAX: 404-233-8012

DATE OF ORDER:___________________________	( For WA only - Date shipped:_____________ )
NAME:______________________________________________________________________________
BILLING ADDRESS: __________________________________________ __________________________________________	SHIPPING ADDRESS: __________________________________________ __________________________________________
TELEPHONE:_____________________________
METHOD OF PAYMENT: (check one) _____ My check is enclosed
Credit Card: ___ VISA ___ MASTERCARD ___DISCOVER ___ AMERICAN EXPRESS
Credit Card Number: __________________________________________________ Expiration Date: ____________
Signature: __________________________________________________________________________

   Qty.
Product #

Description

Unit Price
   Amount

                       Shipping & Handling Charges

Subtotal
   $

If order's subtotal is Shipping charges are
GA Residents: Add 7% Tax
+ $

$0.00 - $24.99 $5.95

$25.00 - $49.99 $6.95
Shipping & Handling
+ $

$50.00 - $99.99
$8.95
Total
   $

$100.00 and over
$10.95

Ikebana vases, kenzans & other supplies

Actual priority mail or UPS cost

Most orders will be shipped within 3 days. We use US (priority) mail unless otherwise requested, or UPS is more cost effective due to the weight and size of the shipment.

Overseas (or destinations outside continental USA)
Actual airmail cost