Print this form and mail money order or check payable to:

Country Glow Soy Candles
1129 Ginkgo Rd
Portsmouth, IA
51565

Print Order Form
http://www.countryglowsoycandles.com/

Day Time Phone (712) 744-3266

Please include name, address, email and telephone number on all correspondences

Name: Use this space below for comments or requests
Address:  
Email:
Phone: ( ________________ )
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Thank You For Your Order! Email me for shipping charges

diane@countryglowsoycandles.com

Shipping &Handling .
Your Order Will Be Processed After Reciept Of Payment. Personal checks must clear the bank before processing order. . Total: .