MEMORABILIA ORDER FORM
ORDER FOR YOURSELF - OR AS A GIFT!

Print out this form and use to order items.

Ordered by: Name_________________________________________________________________________

Street___________________________________________________________________________________

City, State, Zip____________________________________________________________________________

Daytime phone_____________________________________       email_______________________________

Ship if different to:

Name__________________________________________________________________________________

Street__________________________________________________________________________________

City, State, Zip____________________________________________________________________________

______ Check is enclosed (payable to John More Association) Note: Payment must be received in order
            to process your order.

Item #           Description                 Size         Quantity          Price Each     Postage*          Total Price

______        __________________    _____      ________         _________    ________       ___________

______        __________________    _____      ________         _________    ________       ___________

______        __________________    _____      ________         _________    ________       ___________

______        __________________    _____      ________         _________    ________       ___________

______        __________________    _____      ________         _________    ________        ___________

*Please note: Shipping and handling charges apply
                         to Continental U.S. orders only:
                        $4.00 for the first item ordered and              
                        $0.75 for each additional item ordered.
              TOTAL ENCLOSED           ___________
                                                                                             

Today's Date_______________

Send order to: Irma Leigh, 1188 County Highway 21, Walton, New York 13856
email: isl@frontiernet.net