Date:

      

Phone

    

Ship To:

      

Bill to:

    
             
             
             
     

Credit Card

    
     

Expiration Date

    

E-mail:

    

Signature

    

Quantity

Description

Unit Price

Price
       
       
       
       
       
       
       
       
       
       
       
       
   

Subtotal

  
 

North Carolina residents please add:

6.75 % tax

  
 

Please add $4.60 plus 1.5 times the weight in whole pounds

Shipping

  
   

Total

  

Please make checks payable to

New World Textiles

PO Box 1484

Black Mountain, NC 28711-1484

phone/fax 828/669-1870 has automatic fax reception