NAME:                                                                                           

ADDRESS:                                                                                      
              
                                                                                                    

PHONE #:                                                                                      

CREDIT         VISA ____   MASTER CARD ____   AMERICAN EXPRESS ____
CARD #:                                                     EXPIRATION                 

                                                        SUB TOTAL:                           

                                                        TAX   8%                                
                                                        (ILLINOIS RESIDENTS ONLY)       

                                                        SHIPPING                               

                                                        TOTAL                                  
      

                ART CRAFT WIRE                       FAX # : 847-588-0080
                1540 N. LASALLE #304                       
                CHICAGO, IL 60610