The Puzzle & Craft Factory
441 Main St.     Hudson, MA.   01749
Phone: (978) 562-0785
Website: www.puzzle-factory.com         E-Mail: 

Name:_____________________________________________________          Date: ___/___/___

Address:_______________________________________________________________________

City:________________________________   State:________________   Zip:________________

Please provide us with your phone numbers / E-Mail address in case we have questions about your order.

Day: (_______)_______________________     Evening: (_______)_______________________

Your E-Mail Address (if you have one): _______________________________________________ 

 ITEM#  Qty.      PUZZLE NAME                          Price      Total 
|     |      |                                        |         |
|__1__|______|________________________________________|$________|$_________
|     |      |                                        |         |
|__2__|______|________________________________________|$________|$_________
|     |      |                                        |         |
|__3__|______|________________________________________|$________|$_________
|     |      |                                        |         |
|__4__|______|________________________________________|$________|$_________
|     |      |                                        |         |
|__5__|______|________________________________________|$________|$_________
|     |      |                                        |         |
|__6__|______|________________________________________|$________|$_________
|     |      |                                        |         |
|__7__|______|________________________________________|$________|$_________
|     |      |                                        |         |
|__8__|______|________________________________________|$________|$_________
|     |      |                                        |         |
|__9__|______|________________________________________|$________|$_________
|                                                               |
|______________________________________________________Subtotal_|$_________
|                                                               |
|____________Massachussetts Sales Tax - (Residents only) add 5%_|$_________
|                                                               |
|Shipping/Handling:(Continental US only) $1 to $10.00 add $4.50 |
|(E-Mail us for shipping rates outside US) $10 to $50 add $6.25 |
|_______________________________________________Over $50 add 9%_|$_________
|                                                               |
|____Delivery Confirmation (tracking of delivery) $.50 per order|$_________
|                                                               |
|__________________________________________________TOTAL AMOUNT_|$_________
METHOD OF PAYMENT:    U.S. Funds only.   Check or Money Order payable to:   Puzzle & Craft Factory
No COD's            Print out this form,   fill in and mail to address at top of form

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