order form

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Order Form

Name ___________________

Address__________________

________________ZIP_____

E-mail address:________________

Address shipment to be made to
(If different from above)

_________________________

________________ZIP_____

Send check or money order to

11th P.V.I. Preservation
Foundation, Inc.
RD#4 Box 99M
Latrobe,PA 15650

E-mail info@11thpvipreservation.org

Allow 6 to 8 weeks for delivery. Permission is given to copy order form.

Item for sale	Price	Number to be ordered	Total
Sallie Statuette	$45.00		$
"A Colonel, A Flag, and a Dog" by Cindy Stouffer, 84 pages, soft cover	$ 8.00		$
"The Young Mascot" by Gary Casteel unframed 19 inch by 15 inch	$80.00		$
"Devoted Friend" Newfoundland Mascot	$69.50		$

	DONATIONS - tax deductible		$
	MEMORIAL/TRIBUTE FUND - tax deductible		$
	PA Sales Tax (6%) PA residents		$
	Shipping and Handling $6.50 for each Sallie statue, $7.50 for each Newfoundland, $8.00 for each print, $2.50 for each book) (in USA.) call or E-mail for over seas.		$

TOTAL