Printable Mail Order Form
  

Style	Design	Size	Quantity	Price Each	Total
Beret	Beret #1 Beret #2 Beret #3 Beret #4	Choose one Small Medium Large		$39.00
Bella	Bella #1 Bella #2 Bella #3 Bella #4 Bella #5 Bella #6 Bella #7	Choose one Small Medium Large		$72.00
Em	Em #1 Em #2 Em #3 Em #4	Choose one Small Medium Large		$72.00
20's Cloche	Cloche #1 Cloche #2 Cloche #3	Choose one Small Medium Large		$72.00
Viola	Viola #1 Viola #2 Viola #3	Choose one Small Medium Large		$72.00
Miranda	Miranda #1 Miranda #2 Miranda #3 Miranda #4	Choose one Small Medium Large		$72.00
Francine	Francine #1 Francine #2 Francine #3	Choose one Small Medium Large		$72.00
			Sub-Total
	International Shipping & Handling
			Order Total
	Shipping Information
	, - In case we must contact you about your order
Please remember for Each Hat Style to: 1) Select the Style's Design, 2) Select the Size, and 3) Enter the Quantity you wish to Order. Shipping & Handling charges are included on Domestic Orders, on Orders Outside Continental USA Shipping & Handling charges are $25.00 for each, plus $10.00 for each additional hat ordered. The Order Total will be updated each time you enter a quantity. When you have completed your order and entered your Shipping Information, Click the "Print this Order Form!" button to print the order form which you can Mail with your Check or Money Order for the Order Total amount to the address below. All Prices and Charges are stated in US Dollars.
Make Checks Payable & Mail to:		Fountainhead Originals 295 E. Main St #9 Ashland, OR 97520