Keystone Portuguese Water Dog Club

Merchandise Order Form

To order, please contact Anne Paige at anne@paige2.com to check availability. Then print this order form and mail it with your check to: Anne Paige, 109 Vernon Lane, Yardley, PA 19067

Name:

______________________________________

Address:

______________________________________

Address (line 2):

______________________________________

City, State, Zip:

______________________________________

Phone:

______________________________________

E-mail Address:

______________________________________

Qty

Item/Description

Color

Size

Trim

Price
Each

Total

Sub-Total:

Shipping & Handling:
Orders up to $25.00..... $5.50
Orders over $25.00......$7.50

Total Order: