Loon Lamp Order Form
Signed & Dated with Certificate of Authenticity           Original Design by Rose Farmum
Please check one box in each category
of color choices:

BACKGROUND COLORS:
___ A. White Wispy Opal
___ B. Lt. Honey Opal
___ C. Med to Dark Honey Opal
___ D. Ivory Opal (a nice off white)
___ E. Lt. Colonial Blue Opal*
TRIM COLORS:
___ 1. Dk Red Rough Rolled Cathedral
___ 2. Dk Green Cathedral (waterglass or ripple)
___ 3. Dk Amber Cathedral
___ 4. Cobalt (royal) Blue (waterglass or ripple)
___ 5. *Steel Blue Waterglass
___ 6. Med Rose (waterglass or rough rolled)
WATER UNDER LOONS:
___ a. Dk Steel Blue Wispy Opal*
___ b. Blue/Green Translucent Opal
___ c. Med. Royal Blue/White Opal
___ d. Navy Corella Cathedral
___e. Steaky Blue Waterglass
Light Size is 20" diameter w height of 13".
The loons are cut in a solid black opalesent
glass and the white markings are hand
painted and oven baked. This light is wired
with UL lamp wire and a porcelain socket
w/3' lamp chain, wall plug and inline switch.
Ceiling plates are available for installing to
existing home wiring. Your local electrician 
is recommended for this installation.
* These blues are in the blue gray color family 
and compliment each other.

Name:____________________________
Address:__________________________
City:_____________________________
State:_________ Zip Code:__________
Telephone: _______________________
Email:________________________________ 
Loon Lantern Light....... $ 429.00
Maine Sales Tax 5%.....  21.45
Sub total........................ $450.45
Shipping & Handling..... _______
Deposit Paid......................... ________
Total............................. _______

Please add shipping & handling charges if you
do not plan to pick up at my studio. They are 
speically packed, double boxed and insured for safety.
Call with your zip code for shipping cost.
Payment Accepted by Personal Check or 
Money Order.
For custom lamp orders allow 4 - 6 weeks for
completion. A  deposit of $150.00  is required 
with order and any final payments are due before  shipping.
Questions and Comments are welcomed:
Please call: 1-207-583-6151
or email: rosesglass@roadrunner.com

Print this form, complete and send to:

Rose's Stained Glass Studio
430 Naples Road
Harrison, ME 04040-3912