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P.U. Toes Order Form

Name:

Phone Number:

Address: (for shipping purposes)

Street :

City/Prov :

Postal code :

Size

Small: __ Medium: __ Large: __ (mark with an X)

Name of the shoe: (the name by the picture)

Cut and paste this form to an email. Complete the form and email it to me at carriea@mts.net. Once the order is received I will email you an invoice. Alternatively you can call me at 204-654-3021. Should you have any questions about the colors, design, etc, please feel free to contact me. I'll be happy to answer any questions you have.