Order Form and Price Sheet

Phone 812-336-1184 ........ Email..... J@JFarnswoth.com
Jerry's kaleidoscopes are now available in retail stores in the United States, England and Japan. To see a list of the shops that carry Jerry's kaleidoscopes Go To...Retail Locations - Internet sales

Order Form and Price List B A C K T O O L S
Back Rake(Back Scratcher)...... $19.00 Back Roller.....................$19.00 Total $6.50 UPS for any size order.

How to Order
By E-MAIL, When we receive your order, we will E-mail back to verify your order and get your payment information. We do NOT recommend that you send your MC or VISA numbers on E-Mail unless you split the charge card number information into 2 separate emails .
By PHONE, call us at (812) 336-1184
By FAX, Print this page for an order form to FAX.
The FAX number is 812-336-1184. You may include your MC or VISA card number and expire date on this fax.
By U.S. MAIL Print this page for an order form to mail. You may include your MC or VISA card number and expire date to pay by card, or include a check or money order, made out to
J. Farnsworth WoodWorker.
Send to:
J. Farnsworth Wood Worker
2880 E Bethel Lane
Bloomington, In. 47401

Kaleidoscopes
Tiny Teleidoscope 32.00 Delux Oil Scope 50.00 Marble Scope (with stand) 50.00 Marble Block 48.00 Tiny Helix Scope 36.00 Robot 2005 (The Boy) 220.00 Roberta 2004 (The Girl) 220.00 Glass Vase Scope 64.00 Stand 6.00 Train Kaleidoscope 128.00 Sports Car Kaleidoscope 138.00 Crab Kaleidoscope 128.00 Globe Scope 240.00 Pottery Scope 98.00 Double Helix 130.00 Everything Scope 98.00 Cow (Cowlidoscope) 1600.00 Quadra Art Glass Scope 3800.00 Giant Kaleido-bot 3/3 S O L D Rifle Kaleidoscope S O L D Sake Scope S O L D 3 Sense Series Series S O L D

Quantity Description x Cost = Extention
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____________________Total________
______________ __Shipping$ 6.50_
______________Grand Total________

Your Name________________________
Address___________________________
City_______________State___Zip_____
Phone____________________________
Charge type __MC __VISA
Number#__________________________
Expires___________________________
E-mail Address_____________________

U.P.S. Rate $6.50 per order
We have added Paypal Payment buttons on a few of the products. Please go to the product page to purchase through Pay Pal or email us. Thanks! Jerry