Print this form and mail it with your check or money order to:

Anita Foley
21 Olinda Ave.
Hastings-on-Hudson, NY 10706

Please PRINT Clearly:

Item # or Product Name  Description                  QTY  Cost/Item Total     
         
         
         
         
         
         
         
         

TOTAL (mail payment with this order form)

 

SHIP TO:

 Name             Address                  City, State, Zip           Phone # 

 

 

   

 (   )

 

 

Your email address (so we can notify you when your order is shipped):

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