Order Form

M's Countryside Pottery
2134 N. Mutual-Union Rd.
Cable, Ohio 43009
(937)652-1238

Order Form
(Please call or e-mail for latest prices)

Name:_______________________________________________
Address:_____________________________________________
City:________________________________________________
State:________________________ Zip:____________________
Telephone:___________________________________________
E-Mail:______________________________________________

Item#_________________________________
Description____________________________
Design#_______________________________
Quantity:______________________________
Sponging Color:________________________
Price:_________________________________

Subtotal_________
Tax(6% in Ohio)_________
Shipping&Handling (Add 15%):_________

Total:_________

Please send check or money order to:
M's Countryside Pottery
2134 N. Mutual-Union Rd.
Cable, Ohio 43009
(Some items could take 4-6 weeks delivery time)

HOME

DESIGNS

STORAGE JUGS

SHAPES & SIZES

Page Updated on 5/18/2000

Page Done By:
Triple "H" Enterprise
Urbana, Ohio