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| STEVE & LISA HAMMELL c/o Hammell Adoption Fund P.O. Box 129 Geneva, IN 46740 E-mail: [email protected] |
| Name: ______________________________________ Date: ________________ Address: ___________________________________________________________ ___________________________________________________________________ City: ________________________ State: __________ Zipcode: __________ Country: ___________________________________________________________ Phone (H): ______________________ Phone (W): ______________________ E-mail: ____________________________________________________________ |
| ORDER / DONATION FORM |
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| QUANTITY ITEM DESCRIPTION UNIT PRICE TOTAL Spiced Tea $ 8.00 Angel Wings Jelly Jar Candle $ 8.00 Freesia Jelly Jar Candle $ 8.00 Fresh Brewed Coffe Candle $ 8.00 Hot Apple Pie Jelly Jar Candle $ 8.00 Red Hot Cinnamon Jelly Jar Candle $ 8.00 Strawberry Preserve Candle $ 8.00 Tangerine Dream Jelly Jar Candle $ 8.00 Vanilla Jelly Jar Candle $ 8.00 Donation Only $ SHIPPING CHART - Continental U.S. Only ($6.50 Min. - Add .75 each additional item) 1 Item = $ 6.50 Sub-Total 2 Items = $ 7.25 3 Items = $ 8.00 Shipping Charges (See Chart)...Min. $6.00 4 Items = $ 8.75 5 Items = $ 9.50 Total 6 Items = $10.25 7 Items = $11.00 |
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