Mary Louise Gallaway: Order Form

mlgcreations Order Form

Please Note: This is NOT an electronic form.
You may order personalized Initial Brooches by fax or telephone.
Please fill in the desired initials, subtotal, add shipping, insurance and gift wrap costs, add in the French Banking Commission fee, then print out this page, and fax or call your order in to us.

Thank you for visiting mlgcreations!
Mary Louise Gallaway

Name
Your e-mail address
Shipping Address : Street
City, State, Zip
Country & Code
Billing Address : Street
City, State, Zip
Country & Code

Phone Number
Fax Number
Message

Initial	Sequence/Order of Initials	Price @ US $50	Total
	First Letter, Brooch 1
	Second Letter, Brooch 1
	Third Letter, Brooch 1

	First Letter, Brooch 2
	Second Letter, Brooch 2
	Third Letter, Brooch 2
Sub-Total
French Banking Commission
International Shipping & Insurance @ US $20.00
Total

If you have any questions regarding your order, feel free to email us. Please fax or mail form with payment to:

Mary Louise Gallaway
102 Boulevard du Maréchal de Lattre de Tassigny
92150 Suresnes France
Tel: +331 47.72.36.69 Fax: +331 47.28.77.57
E-mail: mlgcreations@aol.com