Please allow approx. 6 - 8 weeks from receipt of your order

for completion and shipment.



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______________________________________________________________________________
Order Form:    
                                                                       Shipping Address if different from order address:

Name:__________________________________          Name:___________________________________
Address:________________________________         Address:_________________________________
City:____________________________________          City:_____________________________________
State:___________________________________         State:___________________________________
Zip Code:________________                                             Zip Code:________________
Phone:__________________________________
E Mail Address:_________________________     

How did you find out about Patches in Glass? _______________________________    

Send the following:

1. Completed Order Form  (Please print off Web site)

2
. The patch that you want used for the Patch in Glass or Ornament

3. A check  or money order for the total  amount of your order         

  NEW PATCHES MAKE A BETTER FINISHED PRODUCT 
  

Please Circle which item you are ordering ( Prices are current for 2014)

    1. Patch in Glass 
-  $100 plus S & H of $20.00   ( $120.00)

    2. Ornament$25.00 plus S & H of $7.50 ($32.50)

    3. Ornament with stand
$30.00 plus S & H of $8.00  ($38.00)      
 

  •  ***** If ordering more than one item please e mail me for shipping costs PRICES CURRENT FOR 2017                       .                                 

    To:  
          Robert Franke
                    65814  East Desert Sands Drive
  •                Tucson, AZ   85739      
  •             

     

                 Please make checks or money orders payable to Patches in Glass