Comfort Curves Order Form

Comfort Curves by Gayle
DELUXE SEAT SAVER CUSHION ORDER FORM

For photos, refer to the English page when making choices for this form. Call (715)455-1652 for custom color or fabric information.

English Seat Saver Cushion	Quantity	Item Price	Total Price
	_______	$38.00	$_________
Top Fabric Choices - Circle or highlight color choice
Faux Sheep 1.Black 2.Brown 3.Gold 4.Natural ("natural" is a polar fleece with sheep texture)
Faux Leopard Skin1.Blk/Brn/Crm multi
Faux Butter Suede (fuzzy) 1.Black 2.Dark Brown 3.Brown 4.Gold (pale)
Polar Fleece Horse Head Print 1.Gold multi (more palominos)
Polar Fleece Tie Dye 1.Bright multi (red, pink, yellow, blue, green, gold, purple)
Polar Fleece Check 1.Bright multi (yellow, lime, pink, blue, orange, purple, moss)
Polar Fleece Solids 1.Charcoal Gray 2.Heather Gray 3.Royal Blue 4.Purple 5.Burgandy 6.Fuschia 7.Barn Red 8.Forest Green
Polar Fleece Camouflage Leaves 1. Greens/browns/grays Polar Fleece Scroll 1. Black 2. Brown
English Seat Saver Cushion + A Little Bit More	Quantity	Item Price	Total Price
	_______	$53.00	$_________
Top Fabric Choices - Circle or highlight color choice
Faux Sheep 1.Black 2.Brown 3.Gold 4.Natural ("natural" is a polar fleece with sheep texture)
Faux Leopard Skin1.Blk/Brn/Crm multi
Faux Butter Suede (fuzzy) 1.Black 2.Dark Brown 3.Brown 4.Gold (pale)
Polar Fleece Horse Head Print 1.Gold multi (more palominos)
Polar Fleece Tie Dye 1.Bright multi (red, pink, yellow, blue, green, gold, purple)
Polar Fleece Check 1.Bright multi (yellow, lime, pink, blue, orange, purple, moss)
Polar Fleece Solids 1.Charcoal Gray 2.Heather Gray 3.Royal Blue 4.Purple 5.Burgandy 6.Fuschia 7.Barn Red 8.Forest Green
Polar Fleece Camouflage Leaves 1. Greens/browns/grays Polar Fleece Scroll 1. Black 2. Brown
Special Instructions: How did you find us?		Sub Total	$_________
Wisconsin Sales Tax (Wisconsin residents only)		5.5%	$_________
Shipping up to $60		$5.95	$_________
Shipping $60 to $120		$7.95	$_________
Shipping over $120		Free	$_________
Total Amount Due			$_________
Credit Card Type (circle one): Visa, MC, AmEx, Disc Credit Card # __________-__________-__________-__________ Expiration Date__________ Security Code (3 digits on back)__________(or 4 digits on front by signature)______________ Name on Card

Name ___________________________________________________Date_________________________

Address ______________________________________________________________________________

City________________________________________ State ________ Zip Code _________

Phone_________________________Email_________________________________________

mail: byGayle
N14397 380th Street
Ridgeland, WI 54763 USA
We will accept your payment with VISA, Master Card, American Express, or Discover by phone or on the WEB, check, money order or credit card by mail. Email:gayle@bygayle.com Phone:1(715)455-1652