| |
| Name:
_________________________ |
| Email:
_________________________ |
| Company (optional):
______________ |
| Address:
_______________________ |
| City:
___________________________ |
| State:
__________________________ |
| Country:
________________________ |
| Zip:
____________________________ |
| Phone: (_____) ______-
___________ |
| |
( ) I am enclosing a
check or money order for $39.97 US. Please note that we do not accept
checks by fax, so if you are paying by US check or money order in US
currency you must
mail it in to the address above.
Please make checks or money orders payable to the "Stony Brook
Vintage Sewing" |
| ( ) I want to charge this
purchase to my Credit Card |