ORDER FORM

Rocky River Designs

If you would like to mail in your Order, please print this page and mail your order to:

Rocky River Designs, P.O. Box 49161, Charlotte, NC 28277

Please type or print clearly.

Sold To:

Name: ____________________________________
Address:___________________________________
__________________________________________
City:______________________________________
State: ________________ Zip: _______________

Ship To: Please fill in information below if items are to be shipped to an address other than “Sold To” address:

Name: ____________________________________
Address:___________________________________
__________________________________________
___Ship Now ___ Ship to arrive week of _______________
Gift Card message:___________________________
___________________________________________
___________________________________________

ITEMS ORDERED:

Item #	Qty	Description	Price Each	Gift Wrap? (Y/N) Free	Total Price

METHOD OF PAYMENT (no Cash or Postage Stamps)
Money Order Personal Check Cashiers Check

Name __________________________________________

Address _________________________________________

City ____________________________________________

State & Zip ______________________________________

Phone ( ) _________________

E-mail ______________________________________

Merchandise Subtotal
Gift Wrap Free
State Sales Tax (See Box "A" below)
USPS Priority Mail Shipping & Handling (See box "B" below)
UPS Shipping & Handling (See box “A” below)
TOTAL

A Express Service, UPS, Shipping & Handling (US & Canada)

STATE SALES TAX INFORMATION:
NC residents or those shipping to NC residents, please add 7.5% sales tax.

Express Services: Eastern, Western, Alaska and Hawaii add $21.95

UPS Services – US Eastern

UPS Ground - $13.95

UPS 2^nd Day Air - $26.95

UPS 3 Day Select - $17.95

UPS Next Day - $39.95

UPS Services – US Western

UPS Ground - $15.95

UPS 2^nd Day Air - $29.95

UPS 3 Day Select - $22.95

UPS Next Day - $49.95

UPS Standard to Canada: $18.95

USPS Priority Mail Canada: $12.95

Express Mail Canada: $22.95

B USPS Priority Mail SHIPPING &
HANDLING (US and territories)

Merchandise Total	Add
$0.00 to $25.00	$ 7.95
$25.00 to $50.00	$ 9.95
$50.00 to $75.00	$ 11.95
$75.00 to $100.00	$12.95
$100.00 to $125.00	$13.95
$125.00 to $150.00	$16.95
$200.00 to $300.00	$18.95
$300.00 or $400.00	$21.95
$400.00 or more	$24.95