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Totem Pole by James Bender at Pike Place Market (#72: 15046 bytes) 

Order Form

Below you will find an order form. Please fill in the blanks and mail it to us with a credit card number, check, or money order, and we will process your order as fast as possible. You will recieve a confirmation notice within 24 hours stating the status of your transaction and information regarding shipment. You can also call us at (206) 780-2326 to leave your credit card number, expiration date, and exact name on your card. Don't forget to leave us your email address so we can get back to you with any questions.

First name ___________________________________________________________
Last name ____________________________________________________________
Middle initial  _______
Street address ________________________________________________________
Additional address or Box #  ___________________________________________
City  __________________________________________________________________
State or Provence  _____________________________________________________
Zip code   __________________
Country ____________________________________________
Day Telephone ______________________________________
Evening Phone ______________________________________
Email address ______________________________________

IMPORTANT: Your package must be sent to a physical address. Please enter the shipping address if it's different from the above.

Street address ________________________________________________________
Additional address or Box #  ___________________________________________
City  __________________________________________________________________
State or Provence  _____________________________________________________
Zip code   __________________
Country _____________________________________________
Day Telephone ______________________________________

PURCHASES

Please go to item(s) that you wish to purchase, and write the title and item number(s) into the boxes below. 

Item:  Title ______________________________________ Item# __________
Item:  Title ______________________________________ Item# __________
Item:  Title ______________________________________ Item# __________
Item:  Title ______________________________________ Item# __________

CREDIT CARD INFORMATION

Name as listed on card  ______________________________________
Credit Card type  ___________________________________________
Credit Card number  ________________________________________
Expiration (month/year)  ______________________________________

Please mail this form to:

Chief Seattle Arts
6621 NE Marshall Road
Bainbridge Island, WA 98110

Customer Service phone:

Customer Service email:

Thanks for shopping at Chief Seattle Arts!
We look forward to your order.

Unless otherwise noted, all images and text are:
Chief Seattle Arts
Last modified: July 01, 2015