Order Form

Mail to:
Poetic Reflections
160 Pine Street #5
Lockport, NY 14094
Telephone: 716-433-5438
Email:Poetic Reflection

We Offer Special Orders
Unframed Poetry $3.95 each or Framed $11.50 plus shipping and handling
Metal frames are available in black, silver, or satin gold.
Wood frames are available in white, dark or light brown maple, or rosewood.
Mounted on a Plak-It Hardboard Plaque $11.95, plus shipping and handling.

*~* For Easy Ordering Print and Mail this form: *~*
Poem Name Qty. Frame Color Total
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Sub Total: $
New York STATE Residents, Please add 4 1/4% Sales Tax $
Shipping & Handling Please Add $5.00 per Item: $
Total Enclosed: $
Payment Options: Check or Money Order
Signature:

Please make checks payable to Poetic Reflections
Payment is payable in US Funds. Please allow 4-5 weeks for delivery.

Thank you for your order. We appreciate your patronage.

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Thank You For Your Order

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