Pops Wood Shop Order Form logo
Ernie Tolive  {}  3225 Twinflower Lane  {}  Virginia Beach, Virginia 23453  {}  USA
Make payable to:  Ernie Tolive  and send to address above!
Check Money Order Cashier Check

Customer Information:

Shipping Information: (if not the same)

Name: Name:
Address: Address:
Address2: Address2:
City: St:  
Zip Code: 		City: St:
Zip Code:
Email Address:
Email Address:   
Telephone:  Telephone:
Ordering Information

Qty

Product Name

Price each

Total
$ $
$ $
$ $
$ $
$ $
$ $
   

Subtotal

 $
   

Tax - VA only (5%) 

 $
   

Shipping & Processing

 $
   

Total Amount Due

 $

Please Make Payment (Credit card or PayPal)
 (do not put in the $ sign)

Enter Amount to be paid:
Please state in the comment box of the shopping cart, 
the purpose of this payment to ensure your account being credited properly!

Website: http://www.popswoodshop.com   {}  Email: customerservice@popswoodshop.com
Phone: 757-434-0166  {}  Fax: 757-368-0689