| Name: | Email: | |
| Address: | ||
| City: | ||
| State/Zip Code: | ||
| Telephone: | Signature: | |
Item Name/Description
|
Qty.
|
Price |
|
|
||
Subtotal: |
||
S/H ($3.80): |
||
Sales Tax (Georgia 6%): |
||
Please make Check/M.O. Payable to Angela Patterson. |
Total: |
|
Thank You!