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Name_________________________                 Send to:  Mrs. Bob Leib
                                                                                   770 Old Lincoln Hwy
Street Address_______________________                      Stoystown, PA  15563
City_______________State_____________                  Phone:814-893-0088
Zipcode_________________________

Phone number where you can be reached_______________________
Email address for contact (optional)____________________________

Style                             Size                    Fabric                 Color














Shipping..............1 jumper..........$7.50; add $ 3.00 for each additional jumper.  Rate subject to change without notice.  Prices subject to change without notice.
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