Quantity 
ITEMS WANTED 
Price 
Dollars | Cents 
WHEN ORDERING WRITE BELOW 
The names of several of your neighbors or friends who have not 
received our Catalog but who you believe might order from us. 
NAMES 
POST OFFICE 
P.O.Box, Street, or R.FJ). 
STATE 
NOTE: Does this order include everything you need? Extra order blanks and envelopes sent upon request 
