Heidi Markish Designs Mail Order Form
Print this form for easy mail order.
Complete your order, send along with your check, money order or Credit Card info to:

Heidi Markish Designs
27 ROBERTS DR.
BURGETTSTOWN, PA 15021
724-947-5093
E-Mail: myheart@hky.com

Patterns $8.95 each - Buy 6 patterns and get 1 free!!
(Please Indicate your free selection)
QTY ITEM NAME PRICE TOTALS
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PA  Residents add   6% tax -                        
Shipping and Handling :
Continental USA Shipping Charges:
* Retail pattern orders - $1.00 PER PATTERN
* Outside the US and Canada must add 20% shipping and handling.
* Wholesale orders - Please contact me
 Shipping & Handling  
TOTAL ORDER  
CREDIT CARD INFORMATION
Name on Card -
Card Number -                                                                    CSC* #: (REQUIRED) __ __ __
Exp.date                                                 CIRCLE ONE:  VISA     M/C   DISCOVER
CUSTOMER INFORMATION
Customer Name
Address
City                                                           State                      Zip Code
Home Phone #                                                       Work Phone #                                                              Email Address

*CSC: last 3 digits on the signature strip on back of card. This is REQUIRED!!

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