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Print This Form and Mail With Payment To
Lanterns Online
5330 Ravenna Rd.
Newton Falls, Ohio
44444
Please send personal check or money order.
Orders will be shipped within 10 days of receipt of payment unless
otherwise stated on the catalog page.

Be sure to check
availability before ordering on the catalog page.
Include $7.00 shipping and handling for the first lantern $3.50 for each additional lantern.





Quantity ___  Lantern Model & Color ____________________    Price _______

Quantity ___  Lantern Model & Color ____________________    Price _______

Quantity ___  Lantern Model & Color _____________________   Price _______

Quantity ___  Lantern Model & Color _____________________   Price _______

Do you wish to backorder any items yes/no_________

Lantern Total ___________

Shipping & Handling ________

Grand Total __________

Ship To

Name ____________________________

Email ____________________________

Address ____________________________________

City ________________________________________

State ____________________   Zip ___________________



 
 
 
 

Dietz Lantern Home
Kosmos Lamp Home
Dietz Lantern Catalog
Kosmos Lamp Catalog
Dietz Lantern Info
Kosmos Lamp Info
Dietz Lantern Order
Kosmos Lamp Order
Dietz Lantern Parts
Kosmos Lamp Parts

 

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