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DS Annex Home Dragon Storm Annex Mail Order Form Name_____________________________________ Mail To: Dragon Storm Annex Address___________________________________ 39 Cypress Road __________________________________________ Chillicothe, OH 45601 Phone #__________________________________ Make check or money order payable to Debby Legner. e-mail____________________________________ Thank you f or your order. Card # Title Price Quantity Total Card # Title Price Quantity Total _____ ___________________ ______ x_______=_______ _____ ____________________ ______x______=________ _____ ___________________ _______x_______=________ ______ ___________________ ______x______=________ _____ ___________________ _______x_______=________ ______ ___________________ ______x______=________ _____ ___________________ _______x_______=_______ ______ ____________________ ______x______=________ _____ ___________________ _______x_______=_______ ______ ____________________ ______x______=________ _____ ___________________ _______x______=________ ______ ____________________ ______x______=________ _____ ___________________ _______x______=________ ______ ____________________ ______x______=________ _____ ___________________ _______x______=________ ______ ____________________ ______x______=________ _____ ___________________ _______x______=________ ______ ____________________ ______x______=________ subtotal a _____________ subtotal b_____________ subtotal a _____________ Shipping & Handling $3.00 Order Total __________ Alternate Cards/Comments ________________________________________ _____________________________________________________________ |
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