Order Blank 
Mr. 
Mrs. 
Miss 
R. D.tor St. 
Post Office 
Ship When 
Quantity 
1. 
2. 
3. 
10. 
11. 
12. 
13. 
14. 
15. 
16. 
17. 
18. 
19. 
20. 
21. 
TR 
beet - 
N 
@o 
(Continued on Other Side) 
DISTINCTIVE GLADS _ order No. 
EVERETT A. QUACKENBUSH 
NEW CUMBERLAND, PA. 
Date 
(Please Print) 
State 
Amt. Enclosed $ 
If We Are Out of What You Order Shall We— 
( ) REFUND ( ) SUBSTITUTE NEAREST SIZE 
VARIETY 
Balance Forward 
- = ES 
- 
( ) SUBSTITUTE NEAREST VARIETY 
Price 
