Print-able Order form

PRINT THIS ORDER FORM AND MAIL WITH PAYMENT INFORMATION TO: Homespun Rug Hooking 3017 E Highview Dr Des Moines, IA United States 50320 Phone #: 515-285-3733 Fax #: Email: psims@mchsi.com
Circle Payment Method: Check Money Order
Print Name:
Address:	Email:
City:
State & Zip:
Telephone:	Signature:_____________________

Item Name and Description	Quantity	Price














Subtotal:
Shipping and Handling:
IA residents must add 6% sales tax-
MAKE CHECKS PAYABLE TO: Patricia Sims	Total :

Thank you for shopping at Homespun Rug Hooking.