ORDER FORM
Please
print:
Name
_________________________________________
Address
_______________________________________
Apt. ________________
City
___________________________________________
State ______________________ Zip Code
___________
Quantity
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Description of
Item
Please print or
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Total
Price |
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Thank you for your order!
It will be
given prompt and careful
attention. |
Merchandise
Total |
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Delivery |
15 |
00 |
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Delivery in Indiana add 6%
Sales Tax |
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Grand
Total |
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If
you need to contact us:
Phone
1-317-255-1443
Email
Inteldes@att.net
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Please
make check payable to: Hoosier Recollections
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Mail
payment to: Hoosier
Recollections
4036
East 62nd Street
Indianapolis,
IN
46220 |
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