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DISPLAY CASE THE COLLECTION FEATURED PIECE GIFTS

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ORDER

Featured Piece - Calico Cat - $109.95

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ORDERED BY

Last Name First Name MI

Mailing Address City

State/Province Postal Code

Country Phone

SHIP TO
(We have to add 6.25% sales tax to all orders shipped to Texas destinations.)

Same as ORDERED BY

Last Name First Name MI

Mailing Address City

State/Province Postal Code

Country Phone

MESSAGE

Outside Announcement (e.g. CONGRATULATIONS BRENDA!)

Inside Personal (your chance to say something really nice)

SPECIAL INSTRUCTIONS

SHIPPING & HANDLING

$00.00 - $15.00 = $3.95
$15.01 - $25.00 = $5.95
$25.01 - $35.00 = $7.95
$35.01 - $45.00 = $9.95
$45.01 - $55.00 = $11.95
$55.01 - $65.00 = $13.95
$65.01 - $75.00 = $15.95
$75.01 - $85.00 = $17.95
$85.01 - $95.00 = $19.95
$95.01 - up = $21.95

PAYMENT METHOD

Visa Master Card

Card Number Expiration Date

AUTHORIZATION

Your Email Address

Thank you for shopping with La Selva International!