ORDER SHEET 
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ACKN Zama ss W. H. Rocers SHIPPEDa. 2 eee 
GREENLAWN, LONG ISLAND, N. Y. 
Mr 
Ship to Per onde he nat 4 0 Riad, Soi i pc eee Came V8, Date. ater on eee 
Miss Please Print Name and Address Plainly 
Etec EEOreIN Or OL. Ft. Lye a eck tg A ned Jae co Wa alta ann Ship When? 22. ee 
PE US GEO LLICG heater a Uietn OBA. eA a ee cee fat MR i eg rc State ecem ie eliat a eM 
PID resem Ch CGM a eee wk Sarl y alt ey ao tee ee Ship via express 0 Parcel O 
If Different from Post Office Post 
IN CASE I AM SOLD OUT OF ANY ITEM, SHALL I 
O) Refund O Substitute Nearest Size C1 Substitute Nearest Variety 
PLEASE BE SURE TO INDICATE 
QUANTITY SIZE VARIETY NAME RATE AMOUNT 
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United States Orders under $5.00 add 25 cents toward postage (over) 
Canadian and Foreign Orders under $10.00 add 50 cents toward postage 
If you do not make the payment, some item in your order will have to be omitted to offset it. 
