ORDERED BY:________________________________________________________________________ SHIP TO: Name:______________________________________________________________________   Address:______________________________________________Apt. _______________   City:___________________________State:_____________Zip:____________ Gift Message:____________________________________________________________________ DAY TIME PHONE: Area Code ________-_________-_____________ ORDER FORM: Product # Color or Flavor 2nd Choice Size Item Description Quanity Item Price Total Price . . . . . . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . If you need more ordering space, just include a seperate sheet of paper. Merchandise Total: . Arkansas Residents Only 6% Sales Tax: . Total: . Method of Payment: Mastercard, Visa, American Express, or Discover Credit card #_____________________________________ Expires:_______-_________ Signature as it appears on the card:____________________________________________________ Shipping will be added according to weight and distance sent. For shipments requiring express delivery or for all orders shipping to Canada, Puerto Rico, or overseas, please inquire by calling us at (501) 327-8049 Mail order to: 5-A Gap View Road   Conway, AR 72032 Call in order to 501-327-8049 or fax order to: 501-327-0511