form

Order Form
Prism Crystals/Choice Communications
55911 N. Thomas Rd.
Benton City,   WA   99320 Order Date:____________                                           (509)588-9033
Sold To:                                                                                                           Ship To: (If different)
Name:      _____________________________   Name:      ___________________________
Address:   _____________________________   Address:   ___________________________
City:         _____________________________    City:         ___________________________
State/Zip: _____________________________   State/Zip: ___________________________
Phone:      _________________________   E-Mail__________________________________

Item Number	Item Description	Quantity	Price	Total
1001	40mm Crystal Heart	.	$14.00	.
1002	28mm Crystal Heart	.	$7.75	.
1003	40mm Crystal Octagon	.	$14.00	.
1004	28mm Crystal Octagon	.	$7.75	.
1005	50mm Crystal Eye	.	$14.50	.
1006	38mm Crystal Eye	.	$7.75	.
1007	38mm Crystal Pear	.	$8.60	.
1008	63x13mm Crystal Teardrop	.	$7.75	.
1009	30mm Crystal Moon	.	$7.75	.
1010	50mm Crystal Star Pendant	.	$14.00	.
1011	40mm Lily Octagon	.	$14.00	.
1012	50mm Crystal Almond Pendant	.	$14.00	.
1013	38mm Crystal Almond	.	$7.75	.
1014	40mm Crystal Star	.	$7.75	.
1015	45x28mm Crystal Leaf	.	$7.75	.

	Subtotal	.
Basic shipping USA is free! Enter any extra shipping service fees here	Shipping
Payment Method - Cashier Check/MO [ ] PayPal [ ]	Tax 8%(WA only)	.
	Total	............