Bath  and Garden Order Form
	ITEM PRICE PATTERN HOW MANY? TOTAL PRICE Soap Dispenser 5" Tall $16.00 Tooth Brush Holder 5" Tall $18.00 Tumbler 4" Tall $10.00 Soap Dish 5 1/2" $10.00 Small Planter w/tray 3 1/2' x 5" $15.00 Medium Planter w/tray 4 1/2" x 6 1/2" $25.00 Large Birdhouse 8" x 6 1/4" $45.00 Mini Birdhouse 5 3/4" x 5" $26.00 Large Bird Bath 14" x 3" $78.00 Small Bird Bath 12" x 2 1/2" $48.00 Wall Vase - Large New $30.00 Wall Vase - Small New $20.00
		Ship To: Name:  ____________________________  Street: _____________________________ City & State: ________________________  Zip Code: __________________________ Phone: (___) ________________________  Order Date:_________________________
			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: _ _ _ _ _ _ _ Mail to: Prairie Springs Pottery 5240 E. Reading Rd. Osseo, MI 49266. Please allow 6 to 12 weeks for shipping, especially 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.   If your merchandise arrives  damaged, please save the original carton and packing materials and notify us within five (5) days and we will send you a replacement.

Sub Total:_________

Sales tax:
MI res.
add 6%     __________

Shipping:
Min.$9.00
or 10%      __________

Total:        __________