Sender Name______________________________________________

Address__________________________________________________

City________________________State_______ZIP_______________

Telephone (_______)________________

Method Of Payment:    Check or money order enclosed $

Please charge to my:        �     VISA   �   MASTERCARD

Card NO.                                                 Expiration Date ____/____

Signature

TO ENSURE DELIVERY IN TIME FOR THE HOLIDAYS PLEASE ORDER BY:

Order Summary

Christmas

DECEMBER 10

My Order

Early December

DECEMBER 1

Gift No. 1

Gift No. 2

Total

PLEASE SHIP TO ME:

Item

Price

Shipping

Total

Shipping Date: �Thanksgiving  � Christmas � As soon as Possible � To Arrive__________

SHIP GIFT BOX TO:    (Please Print)

Name

Address

City                                     State                             Zip

Item

Price

Shipping

Total

Shipping Date: � Christmas  � Early December

GIFT CARD TO READ

SHIP GIFT BOX TO:    (Please Print)

Name

Address

City                                     State                             Zip

Item

Price

Shipping

Total

Shipping Date: � Christmas  � Early December

GIFT CARD TO READ