Terrarium
Secure Order Form

          This is a Secure Order Form, so all your information will be encrypted, and sent Safely. Only I will receive this information, and will send you an e-mail confirmation, and shipping information for your order. Use this form Only for Secure Orders charged to your Visa or Mastercard
          You can also pay by Check or Phone Order


Some Glass colors available (For Town House Only):
Since not all colors are always available
Please select an alternate color for Town House Terrarium

Standard colors: Dk Blue / Lt Blue / Dk Green / Lt Green / Pink / Yellow / Gold / Rust / Lt Purple / Dk Purple / White / Black / Grey / Pink+Blue / Green+Blue

Iridescent Colors: Med. Blue / Lt Blue / Grey / Pearl / Pink /Lt Green / Lilac / Peach


Terrariums:

   
 Teardrop Terrarium 
 		Quantity:   X $80   =     Total:$
Birdhouse Terrarium Quantity: X $80 = Total:$
Snowflake Terrarium Quantity: X $80 = Total:$
Town House Terrarium Color Alternate: Quantity: X $70 = Total:$
Globe Terrarium Quantity: X $65 = Total:$
Large Globe Terrarium Quantity: X $90 = Total:$
Bite Terrarium Quantity: X $40 = Total:$

Shipping & Handling ($14 Per Item): Total Quantity: X $14 = Shipping Total:$
______________________ Grand Total: $


Ship To:
(Skip this if shipping to purchaser)
Name: Address: City: State Zip Phone: e-mail:

Purchased By:
(All Info Required)
First Name: Last Name: Address: City: State Zip e-mail: Phone:
Comments:

On to Payment Method....