'Ippy Clog & Sandal Company: Sven Clogs, Dr. Scholl's Sandals, Maseur Sandals, Stegmann Clogs, Old Friend Slippers & Boots

Mail In Form

Please print out the form below and return via mail.
You may also telephone your order.
Please add $9.00 Shipping and Handling to all Orders.

Ship to:
__________________________________________________________
Name:
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Full Street Address:
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City, State, Zip:
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Telephone:

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*Please include a telephone number on all orders so that we may contact you with any questions. Thank you.

Please indicate payment method:
Check Enclosed
Visa
Mastercard

If you chose Mastercard or Visa, please complete the following:
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Cardholders Name
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Expiration Date
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Card Number

Please indicate which type of shoe you are ordering:
Sven Clog Style Number: ___________________________ Description: ___________________________ Please Indicate Color: ___________________________ Please Indicate Size: ___________________________ Please Indicate Quantity: ___________________________ Please Specify Leather (circle one): Leather -- Suede Please Specify Base Color (circle one): Natural -- Black	Stegmann Clog's & Sandals Please Indicate Color: ___________________________ Please Indicate Size: ___________________________ Please Indicate Quantity: ___________________________ Please Indicate Style: ___________________________
Dr. Scholl Exercise Sandal Please Indicate Color: ___________________________ Please Indicate Size: ___________________________ Please Indicate Quantity: ___________________________	Maseur Sandal Please Indicate Style: ___________________________ Please Indicate Color: ___________________________ Please Indicate Size: ___________________________ Please Indicate Quantity: ___________________________
Old Friend Please Indicate Item: ___________________________ Please Indicate Size: ___________________________ Please Indicate Quantity: ___________________________

*Please add $9.00 Shipping and Handling to all Domestic Orders. *Please call for international shipping rates. (978-356-2122)