Please mail the form and your check/money order to:

Barbara Dunshee Pottery
1060 26th Ave E.
Seattle, WA 98112
(206) 229-3311

Thank you for your business.

Billing Name (first, last)

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Billing Address:

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City:                                              State:                                  Zip:

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Daytime Phone:                                              Evening Phone:

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E-Mail:                                             Would you like to be on the mailing list?        yes        no

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Shipping Name (if different from above):

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Shipping Address:

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City:                                              State:                                  Zip:

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Would you like this gift wrapped? (no charge)               yes               no

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Gift card wording (no charge):

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Item No.__________ $__________ Item No.__________ $__________ Item No.__________ $__________ Subtotal: $__________ Shipping/Handling/Ins*: $__________ Sales Tax**: $__________ (WA residents only) Total Enclosed: $__________

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For a gift certificate, please use a 'GC' in place of an item number and enter a value of your choosing. *Please add 15% of subtotal for shipping, handling, and insurance (max of $30). **WA State residents please add 8.8% sales tax to the subtotal.