ORDER FORM
Print this screen / Fax or Mail to:
Jason's Creations
876 N Lenola Rd Bldg 9A
Moorestown, NJ 08057
Fax: (856)-234-1801 / Phone: (856)-234-3994

Name: ______________________________________________________

      Address: _____________________________________________

         City: ___________________________________

        State: ________________________

          Zip: _____________

Daytime Phone: ____________________________

SHIPPING ADDRESS (If differant than above):

      Address: _____________________________________________

         City: ___________________________________

        State: ________________________

          Zip: _____________

Method of payment:


( )Check or Money Order

( )Visa   ( )Mastercard   ( )American Express   ( )Discover
 

Card #: ____________________________________  Expiration Date: __________ 


Signature: ___________________________________________________


Please send me ____ Rocking Chairs at $59.95 Each: ___________

                                  Shipping Charge: ___________

                             (PA or NJ Sales Tax): ___________

                                      Total Price: ___________

THANK YOU FOR YOUR ORDER!

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© Jason's Creations

Please check the list below for the UPS Ground Shipping Charge to your state:

Alabama AL $5.85, Alaska AK $34.80 (UPS 2nd Day Air), Arizona AZ $9.74, Arkansas AR $9.74,
California CA $9.74, Colorado CO $8.47, Connecticut CT $5.02
Delaware DE $4.76, District of Columbia DC $4.76 Florida FL $5.85
Georgia GA $5.85
Hawaii HI $34.80 (UPS 2nd Day Air)
Idaho ID $9.74, Illinois IL $5.85, Indiana IN $5.85, Iowa IA $7.05
Kansas KS $7.05, Kentucky KY $5.85
Louisiana LA $7.05
Maine ME $5.32, Maryland MD $4.76, Massachusetts MA $5.02, Michigan MI $5.85, Minnesota MN $7.05, Mississippi MS $5.85, Missouri MO $7.05, Montana MT $9.74
Nebraska NE $8.47, Nevada NV $9.74, New Hampshire NH $5.02, New Jersey NJ $4.76, New Mexico NM $9.74, New York NY $5.02, North Carolina NC $5.32, North Dakota ND $8.47
Ohio OH $5.32, Oklahoma OK $7.05, Oregon OR $9.74
Pennsylvania PA $5.02
Rhode Island RI $5.02
South Carolina SC $5.32, South Dakota SD $8.47
Tennessee TN $5.85, Texas TX $8.47
Utah UT $9.74
Vermont VT $5.32, Virginia VA $5.32
Washington WA $9.74, West Virgina WC $5.32, Wisconsin WI $5.85, Wyoming WY $8.47

For all other areas not listed, Please call for Shipping Cost.

Note on Sales Tax:
PA Residents Add 6% PA Sales Tax To The Total Of Chairs + Shipping.

NJ Residents Add 6% NJ Sales Tax To The Total Of Chairs Only.

Philadelphia Residents Add 7% Philadelphia Sales Tax To The Total Of Chairs + Shipping.