Lampwork Bead Order Form
Name
Address
City
State
Zip Code
Phone
[Format xxx-xxx-xxxx]
Fax
[Format xxx-xxx-xxxx]
Email
Filler Beads
Color
Quantity
Price
A1 Gold
$2.00
A2 Silver
$2.00
A3 Pink
$2.00
A4 Blue
$2.00
A5 Copper
$2.00
A6 Seafoam
$2.00
B1 Turquoise/Gold
$2.00
B2 Grape
$2.00
B3 Blue/Copper
$2.00
B4 Blue/Gold
$2.00
B5 Emerald/Blue
$2.00
B6 Blue/Blue
$2.00
B7 Lilac/Blue
$2.00
B8 Lilac/Gold
$2.00
B9 Lilac/Pink
$2.00
B10 Spring
$2.00
C1 Gold
$2.00
C2 Pink
$2.00
C3 Blue
$2.00
C4 Seafoam
$2.00
C5 Copper
$2.00
Payment can be made by Paypal, details will be provided at the time of order.
