Postal Mail Order Form
 Please Print Out Form, then Fill it Out and Mail It Back along with Check or
 Money Order to Artisan Light Works  3650 Marion Street SE Albany, OR 97322
 Please add $4.95 for shipping & handling.

 Desired Product Name____________________________
 
 Product Number__________________________________
 
 Wood Type______________________________________
 
 Glass Color______________________________________
  
 Your Name______________________________________
  
 Address_________________________________________
  
 City_____________________________________________

 State____________________________________________
 
 Zip______________________________________________                                      
    
 Phone with Area Code______________________________
 
 E-Mail Address____________________________________