Lampwork Bead Order Form

Name Address City State Zip Code Phone [Format xxx-xxx-xxxx] Fax [Format xxx-xxx-xxxx] Email Baroque Beads   Color Quantity Price Small Baroque Pastel 15mm x 9mm $4.00 Small Baroque Dark 15mm x 9mm $4.00 Medium Baroque Pastel 15mm x 12mm $5.20 Medium Baroque Dark 15mm x 12mm $5.20 Large Baroque Pastel 15mm x 15mm $6.00 Large Baroque - Dark 15mm x 15mm $6.00   Payment can be made by Paypal, details will be provided at the time of order.