Item #		Size (Bracelets)				Item Description		Quantity		Total
	Total Cost Merchandise
	(MA residents Only):Sales Tax (5%)
	Shipping and Handling
	Grand Total (enclose check or money order to Blackstone River Design)
Your Name:
Your Shipping Address:
City, State and Zip:
Phone:					E-mail:

Please print and fill out this form and mail with check or money order.

Mail to:
Blackstone Bead, 1 Lindy Street, Millbury, MA 01527

Please allow two weeks for delivery. Shipping by Priority mail. Shipping and handling free for purchases $100.00 and over.
Shipping rates are as follows:

Up to       $9.99 ....... $ 2.00
$ 10.00 to 49.99 .......$ 3.00
$ 50.00 to 99.99 ...... $ 4.00
$ 100.00 and over... FREE