Sydell Riverplace Pottery Order Form
www.sydellpottery.com

You may print this form and fax it to (254) 622 3979
or mail it to
Sydell Riverplace Pottery
P.O. Box 5408
Laguna Park, TX 76644Information typed in the fields will be printed.

If you would like to submit your order online, go to www.sydellpottery.com/order.htm
* indicates required field

Item number*
Description
Price
Quantity*
Total Quantity  
  Total Price (add 9% for shipping)  
       
       
Type of order retail wholesale
     
Payment Method* credit card by phone Net30 (apply for Net30)
  credit card by other means check by mail
Type of credit card
Name on card
Card number
Expiration Date


Signature Date
Name*
Business name
Address*
City*, State*, Zip code*
E-mail
Phone

Comment or Special Instructions
(if you type a long message, check the printout to be sure it shows the complete text)

SYDELL® is a registered trademark of SYDELL® Riverplace Pottery. All pottery designs and painted artwork on items produced by SYDELL® are copyrighted and may not be replicated or distributed without the express written permission of SYDELL®.