pants order form
Order Form
Date:.........................
Name:...................................................
Address:...........................City:....................State:.....Zip:.....
Telephone number:........................
e-mail address:............................
Rally Pants
Quantity:....... Size: Sm.... Md....Lg
Color......................
Quantity:....... Size: Sm.... Md....Lg
Color......................
Quantity:....... Size: Sm.... Md....Lg
Color......................
Quantity:....... Size: Sm.... Md....Lg
Color......................
Rally Pants $18.each..........................
+Shipping $3..............................
orders over 3 Qty.$1. each...........................
Total $......................................
Make check payable to: Elaine DeRosa
Mail to: Elaine's Originals
29 Rancho Road
Tustin, CA. 92780