Payment Method:![]() Money Order or Personal Check |
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Product price ..................... 49.95 Product s + h ..................... 12.95 Total price ..................... $ 62.90 |
Name:_________________________________________ E-Mail:________________________________________ Street Address:_________________________________ _______________________________________________ City/State/Zip Code:______________________________ _______________________________________________ ~~~ WILLIAM STEELE 19 Ballard St. Suite G Easthampton, Ma. 01027 |