SZAFRAN ORDER BLANK

BUTTERFLY ORDER BLANK

THERESA SZAFRAN

3448 MCKENZIE DRIVE

ANCHORAGE, ALASKA 99517

V.telephone: 907-245-4111

Just print this form and fill it out then mail it with your check.


BUTTERFLY ORDER FORM
Name            ___________________________________________________________________________________

Address        ___________________________________________ (street address only, no P.O. boxes, please - we ship by USPS)

City or Town   ___________________________________________   E-mail address: ___________________________

State/Zip   ____________________________________    ___________________________                            

Telephone ___________________________

Just fill in the form below and mail it in with payment, or call 1-907-245-4111
BUG ITEM
QTY
UNITS
Description (Specie name, indicate top/under wing view)
Price Each
Total Price
 
 
    
 
 
 
 
  
 
 
 
           
           
 
 
  
 
 
 
           
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 
 
 
 
 
  
 SHIPPING and HANDLING:
 
Add $10.00
 
 
TOTAL DUE:
-------- 
 $

KEY QTY=Number of frames; UNITS=Number of bugs per frame
M.Tortoiseshell-$50.00 ea. Sulphur-$100.00 ea. Swallowtail-$200.00 ea.

http://www.acsalaska.net/~ejszafran