Eileen Melton
Phone: (573) 996-7390

Order Form


Name: Please send me the following:

Address:
QTY

Title

Amount

City:
     

State:
     

ZIP Code:
     

Phone:
     
Enclosed is my check for: $________

Sub total:

 
(Make checks payable to: Eileen Melton)

Insurance (optional):

$3.00

Shipping and handling:

$7.95

Total:

 

Mail Order to the following address:
Eileen Melton
Rt. 2, Box 6585
Doniphan, MO. 63935

Dealer Inquires Welcome!