PRINT THIS ORDER FORM ---- MAIL WITH PAYMENT TO: Patricia Johnson

The First Lady Boutique

830 Keefer Rd.

Girard, Ohio 44420

330-539-0259

                                              E-Mail: www.thefirstladyboutique.com

Circle Payment Method:          Check     (or)    Post Office Money Order    

  Print Name:

  Address:

  Email Address:

  City:

  State & Zip:

  Tax ID #:

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Item Name and Description

(Don't forget to list scent type)

Quantity

Price

Subtotal:  

Shipping from Chart:  

IF YOUR ORDER TOTALS                                    SEND $    .00________$24.00                                              $10.00 $24.01________$45.00                                              $15.00 $45.01________$65.00                                              $20.00 $65.01________$100.00                                            $25.00 $100.01_______$150.00                                            $30.00 Orders over $150.00_Please contact us prior to ordering! You may receive a refund in the mail for overpayments.

OHIO RESIDENTS ADD… 7 % sales tax:  

MAKE CHECKS PAYABLE TO:  Patricia Johnson  

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