"THE VISION" ORDER FORM
www.stowersei.com
Date: ___________________________________
Contact:
 Stowers Enterprises Inc
Organization: ___________________________________   Attn: The Vision
Name: ___________________________________   P.O. Box 1729
Address: ___________________________________   Pilot Mountain, N.C. 27041
  ___________________________________
Tel. No.:
 (877) 368-3615 (toll free)
City,State,Zip: ___________________________________   (336) 368-3615 (in N.C.)
Tel.No.: ___________________________________

Fax No.:

 (336) 368-3675
Method of Payment: ___check   ___money order
E-Mail:
 dstowers@stowersei.com
  ___credit card: __Visa __MC    
  Credit Card Number:___________________________    
No. Quantity Description:

Retail
Unit Cost:
Wholesale  
Unit Cost:  
 Amount:
1. ______ 16" x 19" Print w/Cert.
$20.00
$10.00  
 ______
2. ______ 8" x 10" Print
$10.00
$5.00  
 ______
3. ______ 5" x 7" Greeting Card (Blank)
$2.00
$1.00  
 ______
4. ______ Greeting Card (Box of 10)
$18.00
$9.00  
 ______
5. ______ 4" x 6" Postcard
$.50
$.25  
 ______
6. ______ 2" x 3 1\2" Bookmarker
$.20
$.10  
 ______
Comments: _______________________________________________________
Sub-total:
 ______
_________________________________________________________________
*Tax
 ______
_________________________________________________________________
*Shipping
 ______
_________________________________________________________________
*Total
 ______
*NOTE: Tax, shipping and total costs will be confirmed with you prior to any payment.