Order Form

Site hosted by Angelfire.com: Build your free website today!
Simply print, fill out and send!
NOTE: You might need to save this as ASCII text to get it to print out correctly.
|------------------------------------------------------------------------------------------------------------|
|   ___                                                                                                      | 
|  |___|  Baby Gard unit (24.95) + 3.50 (shipping & handling)                                                |
|                                                                                                            |
|   ___           ___                                                                                        |
|  |___|  Check  |___|  Money Order                                                                          |
|                                                                                                            |    
|  Total Enclosed $_________________________________________________________________________                 | 
|                                                                                                            |                                                                                                            |
|  Print Name ______________________________________________________________________________                 |
|                                                                                                            |
|  Address ______________________________________________Apt. #_____________________________                 |
|                                                                                                            |
|  City/State/Zip___________________________________________________________________________                 |
|													     |	
|  Mail to: B. H. O. Distributors									     |
|	    1700 28th St. S. W.										     |	
|	    Grand Rapids, MI 49509									     |	
|	    (616) 530-0817										     |	
|------------------------------------------------------------------------------------------------------------|