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The Lampworks LOGO
Purveyors of Antique Lighting and Accessories
435 Main Street  ~  Hurleyville, New York 12747

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On-Line Order Form

For your convenience, you may use this form to submit an order. This information will be used only to process your order and in strict accordance with our Privacy Policy. You will receive an order confirmation shortly by return email. Please do not remit any payment until your order has been confirmed as many one-of-a-kind items are subject to prior sale.

> This form to be used ONLY for Browse the Shop or The Book Nook  purchases.

   1. Enter Your Personal Information:
All fields in Section 1 are required for Order Processing
State Enter your 2-letter state abbreviation.
Zip Code Enter your ZIP or ZIP+4.
   2. Enter The Item Information:
Fields with * in Section 2 are required for Order Processing
Item Name * Multiple items OK, use commas.
Item Number * Multiple items OK, use commas.
Price * If multiple items are ordered, enter total of all items.
Shipping If not listed, contact us for a shipping quotation.
Insurance Optional, but recommended, contact us for fees.
Tax New York State residents must add 8.00% sales tax.
   3. Select Your Payment Option:
Please Indicate
Your Method
of Payment
  Money Order
Pay me securely with any major credit card through PayPal!  PayPal [DO NOT remit payment until your order is confirmed!]
   4. Submit Your Order:
Additional Information or Comments

     Your Order Number and your IP Address
     will be recorded for verification purposes.

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