Please complete the following Order Form. You may submit the form electronically, as this is a secure site. If you prefer, you may mail or fax the form. (Note: Secure sites can be determined by the https in the web address).

Before placing your order, please help our marketing department by identifying how you learned about our web site:

  • Print out the order form if you choose to fax it to us.
  • Click on Submit if you choose to email us your order.
  • Click on Reset if you need to correct an error.
  • If you live in the Canada, Australia, New Zealand, England, or Germany please click on the Distribution link above and contact the distributor in your area. Please feel free to e-mail info@cochenille.com if you are unable to get a response from the distributor.

Cochenille Design Studio
P.O. Box 235604, Encinitas, CA 92023-5604 U.S.A.
phone: 858.259.1698 | fax: 760.591.4843 | email: info@cochenille.com

Method of Payment

Credit Card: Check to follow by Postal Service:


Card Type:
Card Number:
Card Expiration:
Card CVV Code:  
   
Name
Address
City
State/Province
Zip/Postal
Country
Email
Phone
Promo Code

Computer:

Order:

Note: If your browser supports JavaScript, line item and order totals will be calculated automatically. You must enter a numeric value (the number 0 is a valid numeric value) in the "Qty" and "Price" columns. To calculate the form totals, simply click out of the field you just entered the number in.

Qty. Item# Brief Description Unit Price Total
 
 
 
 
 
Sub Total
(not including local
CA sales tax)*
$
               Shipping:
   Domestic
   Overseas**
$
$

* California Residents: Your local county sales tax will be added to the order.
**Shipping/Handling Charges for overseas orders will be charged to your purchase at cost.

Domestic Shipping/Handling Charge Information:

Order

Amount

$ 0.00 to $100.00

$6.95

$101.00 to $200.00

$7.95

$201.00 to $300.00

$8.95

$301.00 to $500.00

$9.95

$501.00 and over

6% total sale