ORDER BLANK 
ae NAME aie Mie Che mon frst reguaycotahes 
YOUR ADDRESS 
SHIP TO DATE DESIRED 
(If Different Than Above) 
Quantity Age Kind Price Per 1000 Amount 
| 
a eS SSS 
| 
<. ~42 Es eee eee - 
PRICES F. 0. B. RIMERSBURG, PA.—INCLUDE POSTAGE 
Orders must be accompanied by a Deposit of 25% 1% State Sales Tax 
to be accepted. Include postage unless C. O. D. (SPECIALS PREPAID) TOTAL 
