Order Form

Print out this page, fill in the information, and send it (along with your payment) to:
Western New York Wares Inc.
P.O. Box 733 - Ellicott Station
Buffalo, NY 14205

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| Quantity |        Item Description          | Unit Price | Total Price |
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|__________|__________________________________|____________|_____________|
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Shipping Charges:                                Subtotal  |_____________|
Orders under $25= $4.00                                    |             |
$25 - $49.99=     $5.00   NY Residents add 8.75% sales tax |_____________|
$50 - $74.99=     $6.00                                    |             |
$75 - $99.99=     $7.00                          Shipping  |_____________|
Orders over $100= $8.00                                    |             |
                                              Final Total  |_____________|
(Select one) __ Check  __ Money Order

Ship to: Name:___________________________________________________________

Street Address:__________________________________________________________

City:__________________________________ State:_______  Zip:______________

Email address:_________________________ Phone Number:____________________