You may print this form for your convenience.
| Name:_____________________________________________ Address:___________________________________________ E-mail:_____________________________________________ |
Linda Campanella 74 Pittston Ave. Yatesville, PA 18640 |
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| ITEM DESCRIPTION | ITEM NUMBER | QUANTITY | TOTAL PRICE |
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payable to: Linda Campanella SUBTOTAL |
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| DISCOUNTS & COUPONS | . | ||
| SUBTOTAL | . | ||
| SHIPPING-see terms | . | ||
| Want PRIORITY MAIL? Add $3.00 | . | ||
| ALL ORDERS ADD 6% SALES TAX | . | ||
| TOTAL | . | ||
You may use this label for your payment:
| Linda Campanella 74 Pittston Ave. Yatesville, PA 18640 USA |