Order Form

Valhalla_Laser_Designs

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Fill in and print out your order form, please make a copy for your records.

Name:

Date:

Address:

Phone:

City:

MESSAGE:

State:

Zip:

Country:

Email:

Item #

Item Description:

Quantity:

Unit Price:

Total Price:

TOTAL

Shipping (Read Below)

VISA

Master Card

Last 3 or 4 numbers on back of Credit Card

Card#

Exp. Date

CVC#

Name on Card:

Signature:

This order form is for Credit Card orders only. We charge exact shipping charges which will be added to your order and will reflected on your invoice. All orders are payable in US Funds Only. You can Mail, Fax or E-mail this order using the below information.

Please note: The PAYPAL shopping cart on this site is for U.S. residents only. Shipping rates can’t be figured for International orders.Please call or email to order.

Valhalla Laser Designs
Don Lute, Owner
P.O. Box 3006, 122 Fir Street
Myrtle Creek, Oregon 97457
Phone/FAX: 541-860-5551

All Rights Reserved © 2001 - 2009 Valhalla Designs
All graphics, designs, and artwork on this site are copyright protected. Artwork on this site may not be reproduced in any form or by any electronic, digital, or mechanical means including information storage and retrieval systems.