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CUSTOMER INFORMATION
Name:______________________________________
Address:____________________________________
City,State,Zip:________________________________

Shipping address if different:_________________
City,State,Zip:________________________________

ORDERING INFORMATION
Product#___Description:__________Price:___QTY:__Total:___
Product#___Description:__________Price:___QTY:__Total:___
Product#___Description:__________Price:___QTY:__Total:___
Product#___Description:__________Price:___QTY:__Total:___
Product#___Description:__________Price:___QTY:__Total:___
Product#___Description:__________Price:___QTY:__Total:___
Subtotal:_________
Total :_____________

Customizing and special instructions:____________________
_________________________________________________________

METHOD OF PAYMENT:
(Please Circle One)
CHECK or MONEY ORDER

Please allow 6-8 weeks for delivery.