ORDER FORM

Print this order form out and with the included check or money order send it to:

Ultimate pokemon cards

P.O. Box 523

Tyngsboro, MA 01879

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First Name:________________   Last Name:________________

Address:________________________      City:_________________     State:____

Zip Code:_________

Card Name #1:____________________ Quantity:_____      Price:$______

Card Name #2:____________________ Quantity:_____      Price:$______

Card Name #3:____________________ Quantity:_____      Price:$______

Card Name #4:____________________ Quantity:_____      Price:$______

                                                                                              Total:$________

                                  �Check    �Money Order

Thank you for your time.

        (V)attu

        President of Ultimate Pokemon

        Mattu172@aol.com