Note: Your personal information will be kept in strict privacy and will not be sold. To place an order: Submit this form via email or fax to 970.728.6518. Your check or money order should be mailed to: Kate Clayton Metalsmith, LLC PO Box 2412 Telluride, Colorado 81435

Name: Billing Address: City: State: Zip: Shipping Address: (if different than billing) City: State: Zip: Home Phone: Work Phone: Email: Fax: I would like to order: Meditation Bench: 1 Meditation Bench 2 Meditation Benchs 3 Meditation Benchs 4 Meditation Benchs 5 Meditation Benchs Other Prayer Alter: 1 Prayer Alter 2 Prayer Alters 3 Prayer Alters 4 Prayer Alters 5 Prayer Alters Other Sconce: 1 Sconce 2 Sconces 3 Sconces 4 Sconces 5 Sconces Other Comments: