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XAIPETE NIKΩMEN

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Walking Outside the Box

 Order Form

Buyer's Name______________________________     Address_______________________

Phone____________________________________                  ________________________

Email_____________________________________                 ________________________

Gift recipient's name________________________      

 Occasion (is it a birthday?)___________________       

 Special instructions:___________________________________________________

____________________________________________________________________

Price: $16.95 plus $4.55 shipping/handling (within the United States only)

Qty._______x $21.50         Total Amt. due________________

Please make your check or money order payable to me and send it to Susan Reynolds, P. O. Box 393,                     Hillsboro, NM 88042-0393.  

Questions? Call me at (575)895-3383 or email WalkingOTB@journeyheretothere.com

Thank you for your purchase!  susan

XAIPETE NIKΩMEN (c)2005 Here to There, LLC