Order Form
PRINT OUT THIS ORDER FORM AND MAIL IT TO:
Katie Organ
68185 Nehalem Hwy. North
Vernonia, OR 97064
Include a personal check, cashiers check or money order
for the total amount due including shipping.
Shipping is $1.50 for one pattern and 50¢ for each pattern after one.
| Item Name | Item Code | Retail | Quantity | Total |
| Prairie Rose Ladies Nightgown 6-24 |
NGL1000 | 12.00 | _______ | _______ |
| Prairie Rose Childs Nightgown 2-12 |
NGL1000-1 | 10.00 | _______ | _______ |
| Blue Plate Special Apron Childs, Ladies SM-XLG |
BPS | 9.00 | _______ | _______ |
| Worker Bee Apron Childs, Ladies SM-XLG |
WKB | 9.00 | _______ | _______ |
| Busy Bias Apron Childs, Ladies SM-LG |
BBA | 9.00 | _______ | _______ |
| Bloomin' Apron Childs, Ladies XSM-LG | BA | 9.00 | _______ | _______ |
| Birdhouses Around the Border | BH | 8.00 | _______ | _______ |
| Buckle Jumper Childs 2-12 | BJCH | 9.00 | _______ | _______ |
| Buckle Jumper Ladies 4-26 | BJLA | 9.00 | _______ | _______ |
| Buttons & Charms Mini Quilt | BCMQ | 7.00 | _______ | _______ |
| Criss Cross Jumper Childs 2-14 | CCCH | 9.00 | _______ | _______ |
| Criss Cross Jumper Ladies 6-24 | CCLA | 9.00 | _______ | _______ |
| Jumper Dress Childs 2-14 | JDCH | 9.00 | _______ | _______ |
| Jumper Dress Ladies 6-20 | JDL | 9.00 | _______ | _______ |
| Label Jacket Childs 4-6 Ladies 4-30 | LJ | 9.00 | _______ | _______ |
| Prairie Point Dress Childs 2-14 | PPCH | 9.00 | _______ | _______ |
| Prairie Point Dress Ladies 6-20 | PPLA | 9.00 | _______ | _______ |
| Reversible Apron 1 Size Ladies | RA | 7.00 | _______ | _______ |
| Ruffled Blouse & Skirt Childs 2-12 | RBSCH | 9.00 | _______ | _______ |
| Ruffled Blouse & Skirt Ladies 4-22 | RBSLA | 9.00 | _______ | _______ |
| Scalloped Apron Childs 2-6 Ladies 6-26 | SA | 9.00 | _______ | _______ |
| Shopkeeper Apron Ladies 4-30 | SKA | 9.00 | _______ | _______ |
| Sweetheart Jumper Childs 2-14 | SJCH | 9.00 | _______ | _______ |
| Sweetheart Jumper Ladies 6-20 | SJL | 9.00 | _______ | _______ |
| Tea Cozy | TC | 7.00 | _______ | _______ |
| Work Frock Ladies 6-20 | WF | 8.00 | _______ | _______ |
| Shipping Charges (USPS) | -------- | -------- | -------- | _______ |
| TOTAL | -------- | -------- | -------- | _______ |
| Name: | ____________________________________ |
| Address: | ____________________________________ |
| City/State: | ____________________________________ |
| Zip: | __________________ |
| Phone#: | __________________ |
| Email: |
__________________ |
