Printable Order Form

Print this order form and fax, email, or mail to: Sierra Slate Images 2124 Acton St. Berkeley, CA 94702 tel. 510.845.2816 fax. 510.845.7344 email. slate@lmi.net

Your Name: _____________________________________       Date: ____________

Shipping Address : _____________________________________

City: ____________      State: ___________       Zip: ______________

Tel: ____________      Fax: ___________      Email: ______________

Method of Payment: Visa ____  Mastercard ____  Check ____

Credit Card #: _________________________ Exp. Date: __________

QTY	Item	Size	Description	Unit Price	Total
Shipping fees: $8 for merchandise up to $50 $10 for merchandise up to $50-$100 $15 for merchandise up to $100-$200 Please call us for shipping orders over $200 Please make checks out to Sierra Slate Images All Sales are final All damaged merchandise must be reported within 7 days				SUBTOTAL
				Shipping Fee
				Tax (if in CA)
				TOTAL DUE