Name:
_________________________________________
Address:
____________________________________________________________________
City: ___________________________ State:
____________________ Zip: ______________
Phone / Cell : (
) ______ __________
Ship To: ( ) check here if same as above
Name: _________________________________________
Address:
____________________________________________________________________
City: ___________________________ State:
____________________ Zip: ______________
For Dog: Black ( )
Red ( )
White ( )
Clear ( )
Name: ___________
__________
_________
__________
Quantity (
) Total $ ______
For Cat: Black ( )
Red ( )
White ( )
Clear ( )
Name: ___________
__________
_________
__________
Quantity ( )
Total $ ______
Retail Price:
$34.50 each plus $5.00 Shipping & Handling
Name of Pet in Bronze. Add $10.00
* Illinois Res. Add Sales Tax of 9 1/2%
If tax exempt send copy No.
Total Amount Enclosed $ _________
Make check or money order To:
REMEMBER ME 2
PO BOX 681311
Schaumburg, Illinois 60168
*PLEASE ALLOW 10 TO 14 DAYS FOR DELIVERY.
FOR INQUIRIES CALL: 1-312-834-1693 |