ORDER FORM
KEEPSAKE BOXES
Inside dimensions of boxes with top open: 14-5/8" x 8-5/8" x 4-3/4".
The cover adds 1-1/2" of inside height.
The box has a fine lacquer finish.

Cost per box: $90.

Shipping and Handling: $12./each

Please Print, and Mail Order Form to:
Infinite Branches
515 W. Bethel Road
Bethel, ME 04217

603-466-2265
603-723-5175

info@infinitebranches.com


Name of Purchaser

Name of Recipient

Shipping to Recipient rather than Purchaser? ____Yes ___No
Shipping Address





Telephone # of Purchaser

Email Address of Purchaser

Specific Wellness Energy:

or energy the recipient most needs at the time? ___Yes
Check Amount Enclosed:

Amount to charge to card:

Visa____or Mastercard___
Card Number


V Code


Signature of cardholder:

Note: Maine residents must add 5% sales tax