Printable Order Form

Item:

Please choose the size urn you would like to order:
Small My Puppy Urn 32 Cu. In. $100.00
Large My Puppy Urn 58 Cu. In. $110.00

Please choose the wood variety for your urn:

Please choose which Puppy figurine you want on your urn:

Please choose the color of the engraved name plate:

Text to be engraved:
Example: SPOT
     1984 - 1996

Are you a Florida resident?
Yes (add 6.5% sales tax) No (no sales tax)

To figure Florida sales tax, multiply your sub total by .065
and add that figure to your total.

Item Price: Orderform Calculator

Sales Tax:

Sub Total:

Shipping:

Total Order:

Please fill in the following information:

Name:

Address:

Country:

Phone Number:

Form of payment:

E-mail:

Card Number:

Expiration Date:

Name on the card:

Any special instructions?

Name:
Address:
Country:
Phone Number:
Form of payment:
E-mail:
Card Number:
Expiration Date:
Name on the card:

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If paying by credit card, you can fax your order to...

1-800-409-0314.

Or mail your order to...

Imagination Publications
1910 Needle Palm Dr.
Edgewater, FL 32141

Item Price:		Orderform Calculator
Sales Tax:
Sub Total:
Shipping:
Total Order: