Order Form

You may use this form to place an order by regular mail.

The Lighthouse Smoke Shoppe
P.O. Box 276
Windsor, CO 80550

Stock #	Styles/Color	Description	Price	Quantity	Total








				Subtotal
				CO residents add 3% sales tax
				Shipping and Handling	$5.00
				Total

Make Check or Money Order payable to (Our parent company) Gorgeous Designs.
(Please note that on your credit card statement, the charge will come from Gorgeous Designs.)
Ship To:

Name
Address 1
Address 2
City
State
Zip
Email
Phone
Credit Card #	(Visa or MC)
Exp. Date

Thank you for your order!

The Lighthouse Smoke Shoppe P.O. Box 276 Windsor, CO 80550

The Lighthouse Smoke Shoppe
P.O. Box 276
Windsor, CO 80550