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WEED REVITALIZATION COALITION

SOUVENIR ORDER FORM

QUANTITY     EACH

   AMOUNT

WEED CENTENNIAL
COOKBOOK

$11.95

$ _____________

__________

WEED CENTENNIAL
AFGHAN

$31.95

__________

$ _____________

WEED LIVING HISTORY
VIDEO

$29.95

$ _____________

__________

SHIPPING & HANDLING
$2.95 FOR ANY ONE ITEM
FREE FOR ANY TWO ITEMS

$ _____________

TOTAL:

$ _____________

SHIPPING ADDRESS:

NAME:  _______________________________________________

STREET:  _____________________________________________

TOWN, STATE, ZIP  ____________________________________

PLEASE SEND THIS FORM WITH
CHECK OR MONEY ORDER TO:
  WEED R. C.
590 MAIN ST.
WEED, CA  96094