ORDER FORM PAGE

ORDER FORM Please ship the items listed below Quantity @ $26.95 Name Address City, State, Zip Phone Fax E-mail Total Sale Price Cr. Card Type Cr. Card Number ( Insert First 8 Numbers, We Will Call Back For The Rest ) Expires

For Orders Paid By Check, Print This Form Out And Mail To The Address Listed Below. Do Not Click Submit.

Cummings Enterprises
175 Universal Drive N
North Haven, Connecticut 06473
Phone 203-645-5156
Phone 203-234-7547
Fax 530-452-1643
E-mail a39go39@yahoo.com
Online Info Request Form