VOGIES Quilts & Treasures P.O. Box 367 Dodge, Nebraska 68633 Phone orders -- 402-693-2230 Billing Address Shipping Address __Check if same as shipping address. Name________________________ Name________________________ Address_____________________ Address_____________________ City________________________ City________________________ State_______Zip_________ State___________Zip_________ Country___________ Country___________ Telephone___________________ Telephone___________________ E-Mail______________________ E-Mail______________________ Credit card ____Master Card Name on Card___________________________ ____VISA Card number____________________________ Expiration ____________________________ Qty Item # Title Price Total ____________________________________________________________ ____ ______ __________________________ ________ _______ ____ ______ __________________________ ________ _______ ____ ______ __________________________ ________ _______ ____ ______ __________________________ ________ _______ ____ ______ __________________________ ________ _______ ____ ______ __________________________ ________ _______ ____ ______ __________________________ ________ _______ ____ ______ __________________________ ________ _______ ____ ______ __________________________ ________ _______ ____ ______ __________________________ ________ _______ Subtotal _______ Shipping _______ (NE only 6.5%) Sales Tax _______ Total _______ SHIPPING: The chart below is an estimate according to US Postal Rates. Actual shipping charges may vary according to weight, package size, zone and method of shipment. (Purchase Amt.) (Shipping) 1 -2 Patterns: $1.50 $1 - $20 $1.50 - $4.50 $21 - $40 $4.50 - $6.50 $41 - $60 $6.50 - $8.50 $61 - $110 $8.50 - $10.50 Please check shipping method preferred: US Mail ___ US Priority Mail____ UPS_____ UPS Priority _____ (International orders will have additional shipping charges)