contact us with questions at 802.863.3880        9-5 Monday-Saturday Eastern Standard Time
FAX THIS form after printing and completing to: 802.863.9898
or mail to: Church & Maple Glass Studio * 225 Church St. Burlington, Vermont 05401
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FUSED GLASS
PRODUCT # PRODUCT NAME COLOR/STYLE QUANTITY PRICE TOTAL
#-???? Varied "Gems" pot luck oz.@ $-????-per $
#33m Framed Mirror (10" X 8")+/- Multi-color   $65 $
#33p-h Framed Mirror (10" X 8")+/- Purple-Peach   $65 $
#33b-g Framed Mirror (10" X 8")+/- Blue-Green   $65 $
#33g-z Framed Mirror (10" X 8")+/- Green-Topaz   $65 $
#33z-p Framed Mirror (10" X 8")+/- Topaz-Purple   $65 $
#33p-b Framed Mirror (10" X 8")+/- Purple-Blue   $65 $
#34m Rolled Hor d'ouerve Slab (9" X 10")+/- Multi-color   $170 $
#32m Lg. Framed Mirror (18" X 15")+/- Multi-color   $130 $
#32p-h Lg. Framed Mirror (18" X 15")+/- Purple-Peach   $130 $
#32b-g Lg. Framed Mirror (18" X 15")+/- Blue-Green   $130 $
#32g-z Lg. Framed Mirror (18" X 15")+/- Green-Topaz   $130 $
#32z-p Lg. Framed Mirror (18" X 15")+/- Topaz-Purple   $130 $
#32p-b Lg. Framed Mirror (18" X 15")+/- Purple-Blue   $130 $

EMERALD SEA
PRODUCT # PRODUCT NAME COLOR/STYLE QUANTITY PRICE TOTAL
#16 Small Paper Weight (2"w X 2 1/2"h) Emerald Sea   $35 $
#18 Paper Weight (4"w X 2"h) Emerald Sea   $80 $
#01 Perfume Bottle (3"w X 4 1/2"h) Emerald Sea   $90 $
#04 Nautilus Vase(9"h X 6"w) Emerald Sea   $190 $
#09 Oceana Bowl (13"w X 4"h) Emerald Sea   $270 $
#08 Europa (11"w X 8"h) Emerald Sea   $570 $
#17 Grand Cake Plate (18"w X 9"h) Emerald Sea   $590 $
#07 Amphora Vase(14"h X 7"w) Emerald Sea   $660 $
#06 Odyssey Vase(18"h X 6"w) Emerald Sea   $780 $

FERRIS WHEEL
PRODUCT # PRODUCT NAME COLOR-STYLE QUANTITY PRICE TOTAL
#25z Med. Bowl, footed (9"w X 3"h) Topaz   $96 $
#25g Med. Bowl, footed (9"w X 3"h) Green   $96 $
#25h Med. Bowl, footed (9"w X 3"h) Peach   $96 $
#25p Med. Bowl, footed (9"w X 3"h) Purple   $96 $
#25b Med. Bowl, footed (9"w X 3"h) Blue   $96 $
#25w Med. Bowl, footed (9"w X 3"h) White   $96 $
#28z Lg. Bowl, footed (12"w X 4"h) Topaz   $150 $
#28g Lg. Bowl, footed (12"w X 4"h) Green   $150 $
#28h Lg. Bowl, footed (12"w X 4"h) Peach   $150 $
#28p Lg. Bowl, footed (12"w X 4"h) Purple   $150 $
#28b Lg. Bowl, footed (12"w X 4"h) Blue   $150 $
#28w Lg. Bowl, footed (12"w X 4"h) White   $150 $
#27z Cake Plate (12"w X 6"h) Topaz   $160 $
#27g Cake Plate (12"w X 6"h) Green   $160 $
#27h Cake Plate (12"w X 6"h) Peach   $160 $
#27p Cake Plate (12"w X 6"h) Purple   $160 $
#27b Cake Plate (12"w X 6"h) Blue   $160 $
#27w Cake Plate (12"w X 6"h) White   $160 $
#30z Lg. Cake Plate (14"w X 7"h) Topaz   $190 $
#30g Lg. Cake Plate (14"w X 7"h) Green   $190 $
#30h Lg. Cake Plate (12"w X 7"h) Peach   $190 $
#30p Lg. Cake Plate (14"w X 7"h) Purple   $190 $
#30b Lg. Cake Plate (14"w X 7"h) Blue   $190 $
#30w Lg. Cake Plate (14"w X 7"h) White   $190 $
#29p-h Tower Vase (11"h X 6"w) Purple-Peach   $180 $
#29b-g Tower Vase (11"h X 6"w) Blue-Green   $180 $
#29g-z Tower Vase (11"h X 6"w) Green-Topaz   $180 $
#29z-p Tower Vase (11"h X 6"w) Topaz-Purple   $180 $
#29p-b Tower Vase (11"h X 6"w) Purple-Blue   $180 $
#29h-p Tower Vase (11"h X 6"w) Peach-Purple   $180 $
#29g-p Tower Vase (11"h X 6"w) Green-Blue   $180 $
#29z-g Tower Vase (11"h X 6"w) Topaz-Green   $180 $
#29p-z Tower Vase (11"h X 6"w) Purple-Topaz   $180 $
#29b-p Tower Vase (11"h X 6"w) Blue-Purple   $180 $
#26p-h Platter (15"w X 1"h) Purple-Peach   $196 $
#26b-g Platter (15"w X 1"h) Blue-Green   $196 $
#26z-g Platter (15"w X 1"h) Green-Topaz   $196 $
#26z-p Platter (15"w X 1"h) Topaz-Purple   $196 $
#26p-b Platter (15"w X 1"h) Purple-Blue   $196 $
#24p-h Lg. Encalmo Bowl (13"w X 4"h) Purple-Peach   $236 $
#24g-b Lg. Encalmo Bowl (13"w X 4"h) Green-Blue   $236 $
#24g-z Lg. Encalmo Bowl (13"w X 4"h) Green-Topaz   $236 $
#24z-p Lg. Encalmo Bowl (13"w X 4"h) Topaz-Purple   $236 $
#24p-b Lg. Encalmo Bowl (13"w X 4"h) Purple-Blue   $236 $

TRANSPARENTS
PRODUCT # PRODUCT NAME COLOR-STYLE QUANTITY PRICE TOTAL
#21t Med. Bowl (8 1/2"w X 3"h) Tourmaline   $88 $
#21r Med. Bowl (8 1/2"w X 3"h) Ruby   $88 $
#21c Med. Bowl (8 1/2"w X 3"h) Cobalt   $88 $
#21s Med. Bowl (8 1/2"w X 3"h) Steel Blue   $88 $
#21z Med. Bowl (8 1/2"w X 3"h) Topaz   $88 $
#21p Med. Bowl (8 1/2"w X 3"h) Purple   $88 $
#19z Trumpet Vase (9"h X 6"w) Topaz   $110 $
#19r Trumpet Vase (9"h X 6"w) Ruby   $110 $
#19c Trumpet Vase (9"h X 6"w) Cobalt   $110 $
#20s Pitcher (11"h X 5"w) Steel Blue   $160 $
#20c Pitcher (11"h X 5"w) Cobalt   $160 $
#20t Pitcher (11"h X 5"w) Tourmaline   $160 $
#22t Lg. Bowl (12"w X 4"h) Tourmaline   $170 $
#22r Lg. Bowl (12"w X 4"h) Ruby   $170 $
#22c Lg. Bowl (12"w X 4"h) Cobalt   $170 $
#22s Lg. Bowl (12"w X 4"h) Steel Blue   $170 $
#22z Lg. Bowl (12"w X 4"h) Topaz   $170 $
#22p Lg. Bowl (12"w X 4"h) Purple   $170 $
#23t Xtra-Lg. Bowl (14"w X 5"h) Tourmaline   $220 $
#23r Xtra-Lg. Bowl (14"w X 5"h) Ruby   $220 $
#23c Xtra-Lg. Bowl (14"w X 5"h) Cobalt   $220 $
#23s Xtra-Lg. Bowl (14"w X 5"h) Steel Blue   $220 $
#23z Xtra-Lg. Bowl (14"w X 5"h) Topaz   $220 $
#23p Xtra-Lg. Bowl (14"w X 5"h) Purple   $220 $

PAPER WEIGHTS
PRODUCT # PRODUCT NAME COLOR-STYLE QUANTITY PRICE TOTAL
#35 Confetti Weight (2" 1/2"w X 2"h) Multi-color   $28 $
#16 Emerald Sea Weight (2"w X 2 1/2"h) Emerald Sea   $36 $
#36 Lg. Confetti Weight (4"w X 2"h) Multi-color   $66 $
#18 Lg. Emerald Sea Weight (4"w X 2"h) Emerald Sea   $80 $

Fax this form to (802) 863-9898
-=+=-
...to speak with someone about your order call 802.863.3880

Subtotal 1
5% VT Sales Tax (if applicable) 1
Shipping (see chart) 1
Grand Total 1
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