Bright Moon Productions Logo

I appreciate your interest in Bright Moon Productions jewelry.

Order Form

Name __________________________________________________________

Street _________________________________________________________

City _______________________ State ________________Zip____________

Phone _______________________ E-mail____________________________

Payment Information

Please note that there is a $40.00 fee for returned checks!

__ Check (enclosed) <----- OR -----> __ Credit Card: __ Visa __ MasterCard __ Discover

Name on card _______________________________________

Card Number _______________________________________ Expiration Date__________

Signature ___________________________________________

Please allow 1-2 weeks for delivery.

Mail or FAX Order to:

 Bright Moon Productions, P.O. Box 658, Rockville, MD 20848 - or - FAX: 301.468.0268

Item #

Description

Price

Qty

Total
         
         
         

Maryland Residents Sales Tax (5%)

  

Shipping & Handling - see table below

  

Total

  



Total Purchase

 From

Total Purchase

To

Shipping & Handling Charge
 

$30

$5.85

$30.01

$50

$7.85

$50.01

$100

$10.65

$100.01

$200

$14.25

$200.01

UP

$18.75


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Page last updated December 15, 2005

©2005 Bright Moon Productions all rights reserved.