ARVISTA GARDENS 
168 Grand Blvd. 
Battle Creek,Michigan 
NAME DATE 
STREET 
“erry | ZONE STATE 
AMOUNT ENCLOSED $ . TERMS: Cash with order. 
No COD's please. 
QUANT. 
WANTED IRIS ORDER BLANK PRICE 
is 
e 3 
2, 
: COLLECTION #4 
TOTAL 
