Stephanie Ann
Customer Order Form

PLEASE ALLOW 2-4 WEEKS FOR DELIVERY, THANK YOU!

Stephanie Ann CD - $15 each

To purchase merchandise send order to
Stephanie Ann
Rt. 1 Box 675
Coalgate, OK 74538
along with money order, cashier’s check, or check made payable to Stephanie Ann

SHIPPING & HANDLING
APPLIES TO ALL ORDERS
$0.20 - $20.00    =  $4.00
$21.00 - $30.00  =  $5.00
$31.00 - $40.00  =  $6.00
$41.00 - 50.00  =  $7.00
$51.00 - $60.00  =  $8.00
$61.00 - $80.00  =  $9.00
$81.00 - $100.00  =  $10.00
$100.00 and up  =  $11.00

Name: ________________________________________

Address: ______________________________________

City/State/Zip: __________________________________

Phone: ________________________________________

We accept money order, cashier's check, personal checks made payable to Pake McEntire.,

(U.S. Currency Only)


Item Quantity Price Total
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
Shipping .
TOTAL .