Emerald Forest Pottery

14286 Rd 224  •  Cecil, Ohio 45821

Ordered By:

Name:___________________________________________

Address:_________________________________________

City:____________________________________________

State/ZIP:________________________________________

Phone:(______)________________________________


Ship To:

Name:___________________________________________

Address:_________________________________________

City:____________________________________________

State/ZIP:________________________________________

Phone:(______)________________________________

Color of Trim:_______Item:_____________Cost:______

Color of Trim:_______Item:_____________Cost:______

Color of Trim:_______Item:_____________Cost:______

Color of Trim:_______Item:_____________Cost:______

                                                               Total:______________

                                           Ohio Residents add 7.5%:_______

                                                Pkg. & Shipping:__________

                                                               Total:______________

How would you like it personalized:__________________

______________________________________________

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Cookie Jar  $99 + Pkg. & Shipping of $21.50 Wedding & Anniv. Cookie Jar  $99
+ Pkg. & Shipping of $21.50
Cookie Jar  w/out lid $89 + Pkg. & Shipping of $21.50 Wedding & Anniv. Cookie Jars w/ out lid $89  + Pkg. & Shipping of $21.50
1 Gallon Crocks $89 + Pkg. & Shipping of $21.50 Portrait Tiles  $59
+ Pkg. & Shipping of $12.50
2 Gallon Crocks $129.00 + $23.50 shipping Tile Trays  $129
+ Pkg. & Shipping of $12.50

All Items are double boxed to ensure your order arrives Safely

Orders are shipped UPS or by US Mail  •  Personal Check or Money Order Please
Please Allow 4-6 weeks as all items are handmade  •  Ohio Residents add 7.5% Sales Tax