Minds Eye Design
1 Jefferson Court  Ann Arbor MI 48103
ph 989 493 1804 fax 866 337 8126
      mindseyecards@yahoo.com

order date __________________________
ship date ___________________________
sales rep____________________________
po # ______________________________

____new account ____ reorder

Bill to:
company___________________________
attention ___________________________
street______________________________
city state zip ________________________
telephone___________________________
fax _______________________________
email______________________________
web address_________________________

Ship to:
company__________________________
street______________________________
city state zip ________________________
telephone___________________________
fax________________________________

Terms
______net 30 ____pre-paid check
______visa   _____mastercard
account #__________________________
expiration date______________________
name on card_______________________
signature__________________________

Ship via
_____UPS ground ____USPS
_____other_________________________

Comments:
______________________________________
______________________________________
______________________________________
______________________________________
__________________
Qty
Style #/ Description
Cost
Total