Order Blank DISTINCTIVE GLADS © oyaer No. 
EVERETT A. QUACKENBUSH 
and 
EVERETT F. QUACKENBUSH 
NEW CUMBERLAND, PA. 
Mr. 
De eer ene Date ee 
Miss (Please Print) 
R. D. or St. 
POSE sO ice. eee ee ee ee oe State 
Shin. WW ben. eee ee Amt Enclosed: $ 
If We Are Out of Any Item You Order Shall We— 
( ) REFUND ( ) SUBSTITUTE NEAREST SIZE ( ) SUBSTITUTE NEAREST VARIETY 
Quantity i VARIETY Size Price 
ab 
2. 
3. 
bo 
Ss a] 
bo 
rae 
ES ES ES EE — ae 
Balance Forward 
(Continued on Other Side) 
