| Dynamic Ceramics, Inc. ORDER FORM |
| Comments & Specifications (color, etc.) |
| QTY |
| COST |
| ITEM |
| TOTAL |
| NAME: |
| ADDRESS: |
| CITY, STATE & ZIP: |
| PHONE: |
| E-MAIL ADDRESS: |
| allow 4 to 6 weeks for delivery |
| THANK YOU !! For your Order we will contact you with a total cost including S&H |
| Subtotal |
| *Shipping & Handling |
| Total Due |
| *S&H charges will be calculated by weight & destination |
| copy or attach this order form in an email to fullstar@gtcom.net |