Order Form
(Please Print)
Pine Island Primitives
34995 Staehli Park Road
Lake City, MN 55041

Mailing Address:
City:                                                                State:                        Zip:
Phone:                                                             Email:

Payment Method: (Check One) US DOLLARS ONLY

___ Check                 ___ Money Order                   ___ Credit Card

Card Number:  _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ Exp. Date: _ _ / _ _
Name on Card:   Last 3 Digits on back - _ _ _

If paying by check or MO please make to: Pine Island Primitives

 Quantity  Description  Price  Total

US Shipping & Handling:
$0-$50 - $12
$51-$100 - $14
$101-$200 - $20
$201-$300 - $27
$301-$400 - $34
Over $400 please call or email for costs. International shipping rates.



Tax 8.875% (MN only)

Shipping & Handling  
Balance Due  

Thank you for your order. We appreciate your business.
All prices listed are in US dollars. Please be certain of your purchase. Each of our canvases include a color photo of the finished rug for reference only. The prices shown are for the canvas with the image hand-drawn for you to finish. Not the finished rug. Please be careful of your selections.  All sales final.

Conditions of Use: Check box to complete order
I understand that this hand-drawn rug design (canvas) is for one time use only. I agree not to trace or duplicate it (or any portion of it) in any form or allow anyone else to do so. I agree not to photograph the unhooked canvas or post it on any electronic media until the rug is hooked. If the finished rug is sold, I will permanently attach a tag to the rug that says © Sally Kallin.

I understand that I am purchasing a rug canvas, not a finished rug.

I understand that all sales are final.

If your order is for wool only and does not include a rug canvas, please disregard the copyright information and agree to the Conditions of Use to state that you understand that all sales are final.