Capt'n Tom's MUG Order Form

Print this form from your printer, fill out completely and send with your payment To:

CAPT'N TOM'S ARTWORKS
111 North Stuart Street
Baltimore, Maryland,USA 21221

Please Print:

Name ____________________________________________________________

Street ____________________________________________________________

City, State/Province Zipcode _________________________________________

Phone Number ____________________________________________________

Email Address ____________________________________________________

QUANTITY ________ FULL URL TO IMAGE __________________________________

Please use a different form for each image/logo ordered

RETAIL PRICES:

$19.95 each.......... Shipping included within contiguous USA

$24.95 each.......... Includes international shipping

WHOLESALE PRICES:

Quantity PER IMAGE

12 - 35 mugs.......... $14.95 each.......... Shipping included within contiguous USA

$18.95 each.......... Includes international shipping

CASE PRICE/36 Per Case... Order by the even case only...

$9.95 each.......... Shipping included within contiguous USA

$12.95 each.......... Includes international shipping

TOTAL ENCLOSED: ____________________________

Payable To: Capt'n Tom's Artworks