Rose's Doll House, 12750 W. Capitol Dr. Brookfield, WI 53005
Your Billing Address

Customer # ____  Call 262-781-9660
FAX 262-373-0354


(Credit card orders only) Credit card holders may place their order by phone 10:00 a.m. - 4:00 p.m Central Time. Please have credit card and all ordering information ready. It will help to fill out this order form before calling.
Method of Payment:  __Check   __Money Order    Sorry, No  C.O.D.'s
__ Master Card       __VISA        __ American Express       __Discover

Credit Card Number:_________________________


Ship To:___Business___Residence

#GC Gift Certificate (Any denomination; a gift wrapped catalog and signed certificate will be sent.)  Include $3.00 for postage and handling. 

Room Name


Item #

Description Of Item

Price Ea


Prices are subject to change without notice: Check here if close substitutions are not accepted__
Gift Wrap; Please gift wrap and include a card to read:
Sorry, Doll house Kits, house extensions, and display platforms cannot be gift wrapped      $5.00
Ground Service
Shipping & Handling charges
Packing, postage and insured delivery
to each destination in the Continental United States.
For Orders:
$   .00 to $  9.99.....add  $5.50
$10.00 to $19.99......add $6.50
$20.00 to $29.99......add $7.50
$30.00 to $39.99......add $8.50
$40.00 to $49.99......add $9.50
$50.00 to $59.99......add $10.50
$60.00 to $69.00......add $11.50
Over $70.00....add $12.50

Applies to most orders in Continental U.S.
Alaska or Hawaii $6.00 additional to regular shipping charges.

Additional charges
3 day select add  $15.00
Second Day Air add $20.00
Next Day Air add $25.00
  Call for shipping charges  outside the U.S.A. Call for charges on larger models, Doll houses, wax, clay, paint,



Shipping & Handling (see chart)


Additional  charges if any 




WI residents add  sales Tax
for items delivered in WI.


Less Credit Voucher/Return/free


Final Total