mainstreetpiqua.com

Order Form

Thank you for your interest in purchasing

Piqua merchandise
from mainstreetpiqua.com.

Please fill out the appropriate information and mail this form and a check or money order to:

Mainstreet Piqua, Inc.

PO Box 1703

Piqua, OH 45356

Once your payment has been received and processed your items will be mailed to you.

Be sure to give us a complete (valid) mailing address.
We apologize but we cannot accept credit cards at this time.

Item			QTY		Unit Price		Total
Piqua “Where Vision Becomes Reality” Mug					$14.00
Piqua Postcards – Complete set of 6 cards					$5.00
Taste of the Arts Apron					$20.00
Linear Park Collectible Patch					$4.00
Fort Piqua Hotel Charm (silver finish)					$20.00
Fort Piqua Hotel Lapel Pin (Gold finish)					$15.00
Fort Piqua Hotel Coasters ($7 each or two for $12)
Doug Smith Watercolor Notecards					$10.00
Gazebo Notecards (Winter Scene)					$10.00
1957 Driving Tour of Piqua DVD					$10.00
Fort Piqua Hotel Mini Crock					$15.00
Total Merchandise						$
Shipping & Handling Total Merchandise up to $10.99 -$2.00 Shipping & Handling Total Merchandise above $26.00 to $50.00 - $8.00 Shipping and Handling						$
If merchandise totals more than $50 please email us at info@mainstreetpiqua.com for prices.
Total Check/Money Order						$
Name:				Please Complete this form and mail to: Mainstreet Piqua, Inc. PO Box 1703 326 N. Main Street Piqua, OH 45356
Company:
Address:
City:	State:	Zip:
E-mail:
Phone:

If you have any questions please feel free to contact us at info@mainstreetpiqua.com