ORDER FORM:

Date:_______________________

Name:___________________________________________________
Street:___________________________________________________
City:________________________________ State:________________
Zip Code:_________________Phone #: (       )____________________
email:___________________________________

Quantity	Description	Price Per Item	Total
Merchandise Total
Shipping and Handling (Add 10% of Total Cost)
Sales tax: (.059)
GRAND TOTAL

Payment Method:
(   ) Check (   ) Money Order     *Payable to: Christine L. Hile ===============================================================

For Office Use Only

Date Received: Date Shipped:

=============================================================== Please remit in U.S. Funds Only. Thank you.