PineCreekCeramics.com
For Checks or Money Orders Only, Please Print this page and fill in the information from our
catalog and mail with your payment to: Pine Creek Ceramics, HC 68, Box 85,Valliant, OK 74764
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Shipping
Weight
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Sub-Total Shipping Weight & Prices of Items
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OK Residents Please Include Sales Tax
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Insurance Is Included With S&H
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Grand Total
Please include check or money order for this
amount. Checks may require additional
processing time.
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Ship to
Name:________________________________Address:______________________________
City_______________ State____ Zip_______
Please include contact information in case we have a question about your order.
Email ________________________________Phone (_______)_______________________
Mail Completed Order
and Payment to:
Pine Creek Ceramics
HC 68, Box 85
Valliant, OK 74764
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