Moms Store Order Form

Please Read Instructions 
1: select Product   2: select quantity   3: select total shipping

total_shipping 1item=$2.95 2 items=$5.90 3 items=$8.85 4 items=$11.80 5 items=$14.75 6 items=$17.75    

Your name:
Email address:

Bill To?                                         Mail To (if different)?
   
How would you like to pay for the clock?
 Personal check  money order

PLEASE READ!!!!
Before clicking on submit please double check to make sure all information is correct
If paying by Personal check or Money Order make payable and send them to M Harper 6132 Lovell Valley Rd  Plummer, Id. 83851.   after clicking submit click HOME at the top of the page