Order Form

Emerald Forest Pottery

14286 Rd 224
Cecil, Ohio 45821

Ordered By:

Name:___________________________________________

Address:_________________________________________

City:____________________________________________

State/ZIP:________________________________________

Phone:___(______)________________________________

Ship To:

Name:__________________________________________

Address:_________________________________________

City:___________________________________________

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	Home Cookie Jars $89.00 + $12.50 shipping		Church Cookie Jar $89.00 + $12.50 shipping
	Home Cookie Jars w/out lid Crock $79.00 + $12.50 shipping		2 Gallon Church Crock $99.00 + $15.50 shipping
	2 Gallon Home Crocks $99.00 + $15.50 shipping		Personalized Cookie Jar (6.5"x9") $89.00 + $12.50 shipping
	2 Gallon Name Crocks $99.00 + $15.50 shipping		Personalized Crock (6 1/2"x8") $79.00 + $12.50 shipping
	2 Gallon Heirloom Crocks $99.00 + $15.50 shipping		2 Gallon Library Crocks $99.00 + $15.50 shipping
	Cinnamon Roll Baking Dishes $24.00 + $7.50 shipping		Church Crock $79.00 + $12.50 shipping

Color	How would you like to have the front personalized, such as, "The Warner Home," or "Terry & Susan" Est. 1993	Price

You may add a special message on the bottom of your pottery, such as "Christmas 2006," "Love Susan," or "Welcome to your new home," or your favorite scripture verse. _______________________________________ Your Own Message	Subtotal	______
	Ohio Residents add 7.0% Sales Tax	______
	Packaging & Shipping	______
	Total	______

All items are double boxed for shipping.