Name: __________________________________________________________
Address: ________________________________________________________
City: _________________________ State: ______ Zip code: ______________
Phone: _________________________Fax: _____________________________
E-Mail: _________________________________________________________

Payable by check, Visa, MasterCard or American Express
Send check payable to "Design Guild, Inc." and order form to:
4906 SW 61 Avenue
Ft. Lauderdale, FL 33314 USA

For credit card orders, complete form and fax to 954-321-6524 or mail to address above
Credit Card: _______________________________Exp. Date: ______
Name as it appears on card: __________________________________
Signature:________________________________________