Ship to: (please print)

Name

Address

City, State, Zip

 ______________________________________________________________________________
  Qty   |    Item     |    Style    |    Size     |    Color    |Price         
 ______________________________________________________________________________
        |   T-Shirt   |             |             |             |$             
 ______________________________________________________________________________
        |  Sweatshirt |             |             |             |$             
 ______________________________________________________________________________
        |                              Coffee Mug |             |$             
 ______________________________________________________________________________
        |                                              Tote Bag |$             
 ______________________________________________________________________________
        |                                                Magnet |$             
 ______________________________________________________________________________
        |                                        Bumper Sticker |$             
 ______________________________________________________________________________
        |                  Copies of Angel Country @ $9.95 each |$             
 ______________________________________________________________________________
                                                       Subtotal |$             
 ______________________________________________________________________________
                                         Maine residents add 6% |$             
 ______________________________________________________________________________
                                             Postage & Handling |$             
 ______________________________________________________________________________
                                          Total Amount of Order |$             
 ______________________________________________________________________________
             Postage & Handling:  Add    $2.50 for book alone
                                          
                                         $4.50 for orders up to $20.00

                                         $5.50 for orders over $20.00

Charge my:

Date:   _____ /_____ /_____

Account No.     __ __ __ __      __ __ __ __      __ __ __ __     __ __ __ __

Expiration Date: _____ / _____

Signature: __________________________________________________________