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Customer Information
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Name
(First
and Last)
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Company
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Street
Address
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Apt. or Suite
Number
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City
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State or
Providence
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Zip Code
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Country
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Daytime
Phone
(required)
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Evening Phone
(required)
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Email Address
(required)
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Product
Information
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Select product
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Select primary
clay color
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Secondary colors
are chosen by the Artist
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Quantity
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Note
to
Artist
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Note the color of hair & wings here
Shipping
Information
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Ship to
address
above
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Please check this box
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Ship to
alternate
address
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Please check this box
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Name
(First and
Last)
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Street Address
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City
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State or
Providence
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Zip Code
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Payment
Information
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Payment
Method
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Mail Checks
and Money
Orders to:
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Email Artist at LindaRae@afairyartist.com for current
mailing address.
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We will be contacting you by phone and/or
e-mail to verify and confirm your order.
Thank you for your business!
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