BATH AND GARDEN POTTERY ORDER FORM
We offer a choice of colors and patterns.
White/Blue Rim - Bluebonnet ( B / B ) White/Green Rim - Iris ( G / I ) Blue' Brown/Tan ( B / B / T)
White/Blur Rim - Country Floral ( B / F ) White/Rose Rim - Rose ( R ) Green / Brown / Tan ( G / B / T )
Blue / Green ( B / G )
(See our "Collectibles" Page for Country Folk Art Patterns and Other Items)
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Butterfly Puddler
(feeder)
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Form of payment:
Enclosed is my check or money order for $__________ Please make payable to: Prairie Springs Pottery
Visa___ Master Card ___Credit card No. ______________________________________
Expiration Date:___________CVC#_________( 3 digit number from back of card)
Please allow 6 to 12 weeks for shipping, on special orders. Please Note! We accept Master Card and
Visa only. We are unable to process credit card sales on-line. We ship via U.P.S. and we record all
tracking numbers. If there is a problem with your shipment, please notify us immediately.
Ship to:
NAME____________________________ADDRESS__________________________________
CITY_____________________________STATE______________ZIP_______________
PHONE NUMBER: (______) ______ - _______________
Please mail this order to:
Prairie Springs Pottery 5240 E. Reading Rd. Osseo, MI 49266
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MI
Residents
Add 6%
Sales Tax
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