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To order, print this form, complete and mail to: Name: _______________________________________________ Agency: _____________________________________________ Address: _____________________________________________ City: _________________________________________________ State: _______________ Zip:___________________________ Phone: ( )_________________________________________ Fax: ( )___________________________________________ E-Mail: _______________________________________________ Quantity_____________ @ $8.95 = $_______________________ Iowa Residents add 5% $_______________________ Shipping and Handling $_______________________ TOTAL $__________________ | Thank you for ordering...
Quantity Discount
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Check Enclosed:______ Charge to: _____ _____
Carefully write your Account Number:
Authorized Signature_______________________________________ | |||||||||||||||||||||
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Please e-mail (lovekids@adoptionstuff.com) or call our sales department at (319) 365-3454 for further questions. For orders outside the U.S., please contact us at (319) 365-3454 or by e-mail before ordering. All prices and shipping rates are subject to change. | ||||||||||||||||||||||