ORDER FORM
Date: / /200..
___________________________________________________________________
Merchandise Mailed To:
First:_________________
Last Name:______________________
Company's Name:______________________________________
Street Address:_____________________________________________
2-Adress:____________________________________________
City:___________________
State:___________
Zip code:__________
Country:________________________
Day-time-tel#:( )__________________
Item(s) Description:____________________________________________________
Price(s):$_____________________________
Sub-total:$__________
Plus Taxes(where applicable):$___________
Plus Shipping and Handling:$___________
Total charge:$__________________
Feedback:________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Note: Mail this order with your check or see "How To Pay" below:
Mrs. Ellie Kondy
73 King Street
Floral Park, NY 11001
http://www.gmas-ellie.com/
Copyright © 1996/2010, Ellie Kondy
