NAME 
STREET 
CITY 
AMOUNT 
QUANT, 
WANTED 
ARVISTA GARDENS 
168 Grand Blvd. 
Battle Creek,Michigan 
DATE 
ZONE STATE 
ENCLOSED §$ - TERMS: Cash with order. 
No COD's please. 
IRIS ORDER BLANK 
COLLECTION #1 5. 00 
COLLECTION #2 10. 00 
COLLECTION #3 13. 00 
COLLECTION #4 4.50 
TOTAL 
PRICE 
