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Selection of
LAMPSHADE MATERIALS:
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SWATCHES

You may request up to 3 swatches.
There will be a $5 charge to cover the cost of shipping, handling and material
 The $5 will be reimbursed with your first order of lampshade/s placed.

SECURE ORDER FORM



************************************Order form for Swatches only******************************************
We do not sell, share or solicit from any of the information you submit to us

First Name: Last Name:
Email: Phone Number:
Ship to: (Name) Skip if to same as above :
Address Line 1:
Address Line 2:
City: State: Zip:
Card Type:
Name as it appears on Card:
Credit Card #: Expiration:
Swatch#1:
Swatch#2:
Swatch#3:
Total to be billed: