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Order Form to Mail or Fax

Fax to 903-223-9143
Mail to:  Lynn & Barton * 4 Shadow Dr * Texarkana, TX  75501-9520
Make checks and money orders payable to:  Lynn & Barton

Fill in the order quantity beside each item you wish to order.

Signature Candle Lamps - $29.99 each

______ Black     ______ Brass     ______ Pewter    ______ Antique Taupe    ______ Antique White    ______ Bronze

Replacement bulbs for Aurora Signature Candle Lamp ™ 

______ NP4 20 Watt Lamp Replacement Bulb - $6.99 each or 2 for $13.00

______ NP5 20 Watt Lamp Replacement Bulb - $7.99 each or 2 for $14.00

Additional Lamp Shades

______ Green - $8.99

______ Orange - $8.99

______White Frosted Shade Replacement - $5.99

______ Red Floral Hand Painted - $11.99

______ Yellow Floral Hand Painted - $11.99

______ Floral Tiffany Style - $16.99

______Beige Tiffany Style - $16.99

______Dragonfly Tiffany Style Shade - $16.99

______Christmas Shade - $14.99

16 oz Candles - $14.99 each
28 oz Candles - $25.99 each

10 oz Classic Jar or Rectangle Jar Wicked Candles - $10.00 each

Choose type of candle:  _____16 oz Balmoral Jar Wickless Candle    _____28oz Apothecary Jar Wickless Candle

or _____10 oz Classic Jar Wicked Candle    _____10 oz Rectangle Jar Wicked Candle

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Would you like to suggest that we carry a particular scent? _______________________________________
                                                                                                          name of scent suggested

Contact Information

Email Address______________________________ Confirm Email Address______________________________

Day Phone ________________ Evening Phone ________________

Shipping Information

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Recipient's Name

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Business Name (if applicable)

____________________________________________
Street Address
Be sure to include apt or suite no if applicable

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City, State, Zip Code

 Billing Information      _____same as shipping

____________________________________________
Recipient's Name

____________________________________________
Business Name (if applicable)

____________________________________________
Street Address
Be sure to include apt or suite no if applicable

____________________________________________
City, State, Zip Code

Delivery Charges - orders normally delivered within 2 to 5 business days.
       $6.95 for Bulb Only Orders
       $9.95 for orders up to up to $50.00
       $12.95 for orders over $50.00 & up to $100.00
       $15.00 for orders over $100.00 & up to $150.00
       $20.00 for orders over $150.00

$5.00 Texarkana Area Delivery Charge

Payment Details

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Master Card or Visa Number (16 Digits)

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Credit Card Expiration Month / Year

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Signature of Card Holder                                                            Date

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