By submitting this form, you attest that all information on it is correct and current.
You do not have to send this order through
If you would prefer, simply print this form out and mail or fax it to, but please be sure that
I have confirmed your order and that I have the item in stock before you mail any payment to me:
Address: Edie Schneider - P.O. Box 693, Grover Beach, CA
Phone / Fax: 1-805-481-7309
will contact you to confirm your order.