Botanical Lampshades

Botanical Lampshades
95 Foss Flats Road, N. Sandwich, NH 03259 / Phone 603-284-7468

LAMPSHADE ORDER FORM
(view ordering information for lampshade sizes, prices, shipping information, etc.)

SHADE 1

Please Specify Shade Dimensions Completely:
TOP diameter: _____ " BOTTOM diameter: _____" SLANT HEIGHT: _____"

Top fitting (select one):
Clip _____ Washer _____ Bridge _____
Bowl _____ Chimney _____

Select Color: Standard background color is white.
Cream or Tan is also available at 10% surcharge.
Select One: White _____
Cream (+10%) _____ Tan (+ 10%) _____

Enter Lampshade Design #: _________________
OR
Describe your preference for colors, flowers, and design. Sketches, fabric or wallpaper swatches are helpful. Use additional sheet of paper if needed:

________________________________________

SHADE 2

Please Specify Shade Dimensions Completely:
TOP diameter: _____ " BOTTOM diameter: _____" SLANT HEIGHT: _____"

Top fitting (select one):
Clip _____ Washer _____ Bridge _____
Bowl _____ Chimney _____

Select Color: Standard background color is white.
Cream or Tan is also available at 10% surcharge.
Select One: White _____
Cream (+10%) _____ Tan (+ 10%) _____

Enter Lampshade Design #: _________________
OR
Describe your preference for colors, flowers, and design. Sketches, fabric or wallpaper swatches are helpful. Use additional sheet of paper if needed:

________________________________________

If ordering the lampshade kit, please enter quantity here: _____
Kit costs $35, plus $8 shipping via U.S. Mail anywhere with in the continental United States.

If ordering the mason jar adaptor, please enter quantity here: _____
Adaptor costs $10.00, plus $3 shipping via U.S. Mail anywhere with in the continental United States.

Enclosed is a check for: $ _______
     Lampshade
Shipping and Insurance Charges

Shades $_________
Total Order

Shipping/Insurance Charges

Color Surcharge $_________ Under $60.00 $15.00

$60.00 - $75.00 $20.00

Lampshade Kit $_________ $75.00 - $100.00 $25.00

Mason Jar Adaptor $_________ $100.00 - $200.00 $30.00

Shipping $_________

Total
$_________

Note: Is the lampshade you are ordering 14" in height or diameter or larger? If so, an additional USPS shipping surcharge of $10.00 is required. More information regarding this surcharge is available on our Ordering Information page. Please do not hesitate to contact Botanical Lampshades with any questions.

$_________
$10 Surcharge if Applicable (14" or larger)

Total Order: $_________

Customer Information:

Name: ________________________________
Street: ___________________________________________________________
City: _____________________________ State: _____ Zip: _______________
Phone: ( ____ ) ______________________ Email: ________________________