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BartArt Order Form

All information entered on this secure form will be kept confidential.


Your Name: 
(required)
Email address: 
(required)

BartArt ID Quantity

  Product Name

  Wood Request
1
2
3
4
5
6
7
8
9
10

Comments:

(quantities, special instructions)


Shipping Options:

(Shipping amount will vary based on currier)


Use the address information from a previous order?

Yes -
No  (If not, please continue below.)

Shipping address Line 1: 
(or company name)
Shipping address Line 2: 
(optional)
City: 
State/Province/Region: 
ZIP/Postal Code: 
Country: 
Phone Number: 
(we will use email first)
Fax Number: 
(we will use email first)

Is this address also your billing address?

Yes -
No  (If not, please continue below.)

Billing address Line 1: 
(or company name)
Billing address Line 2: 
(optional)
City: 
State/Province/Region: 
ZIP/Postal Code: 
Comments or additional shipping instructions: 
(optional)

 

 

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Last modified: May 08, 2005