BRACELET  ORDER FORM

I would like to order  _____ bracelet(s)  @ $2.50 per bracelet.  (Includes shipping) 

Enclosed is a Check/Money Order in the amount of: $__________ 

Name:_____________________________________

Address:___________________________________

City:_________________________   State:________  Zip Code:________

Email Address:_________________________________________________

Send this form with check to:

Sylvia Ackerson
1034 Bayside Lane-BSL    
Southport, NC 28461-9650

If you have any questions please contact Sylvia at nyamom@atmc.net

It might be a good idea to contact Sylvia via email to let her know you are sending an order so she can put the bracelet(s) aside with your name on them. 

© Sylvia Ackerson 2011