Order Date:
Mail or fax your order to 2658 County Road I, Sauvkille, WI  53080 Fax 262-268-5188
Internet orders at www.shadowdanceaussies.com/store.htm
SOLD TO:						CHECK PAYMENT METHOD USED:
						○ Check or Money Order enclosed
Name						○ Discover		○ Mastercard		○ Visa
Street						Card Number
City		State		Zip		Expiration Date
e-mail						Name as it appears on card (please print)
Phone
						Signature of card holder
SHIP TO:  (If different than Sold To.)
						Billing address
Name						Street
Street						City		State		Zip
City		State		Zip
e-mail
Phone
Item		Qty.	Description				Color	Size	Unit Price	Total
									Subtotal
Shipping									Shipping
If order totals					WI orders add 5.6% sales tax				Tax
	Up to $15.00 add $5.50								Total
	$15.01 - $25.00 add $7.50
	$25.01 - $35.00 add $8.50
	$35.01 and Over add $10.50