MERCHANDISE TOTAL $______________

 

Please select one of the following:

 

I will pick up my order ________ (no additional charge).

 

Please ship my order ________

You will be contacted regarding shipping costs.

 

 

 

Name: ______________________________________________________

 

Local Address: _______________________________________________

 

Phone #: ____________________________________________________

 

Email: _______________________________________________________

 

Ship to Address: ______________________________________________

 

THANK YOU!

 

 

 

Please print and mail with payment * to :

Laurie Pearson

The Queen Lake Store

P.O. Box 515

Templeton, MA 01468

 

* unless items are being shipped to you, in which case

please wait until I contact you with the shipping charges.