Souvenirs
ORDER FORM
Please print clearly.
Name    _______________________________________________________
Address _______________________________________________________
City    ______________________________ State ______ Zip Code  ______ 
Totebag (18 left) $5.00 each Quantity ________ Subtotal ________
Postage & Handling
(1 totebag)
$2.00 Quantity ________ Subtotal ________
Set of 4 coasters (15 sets left) $5.00 each Quantity ________ Subtotal ________
Postage & Handling
(1 set of 4 coasters)
$3.95 Quantity ________ Subtotal ________
Larynards (8 left) $1.50 each Quantity ________ Subtotal ________
Postage & Handling
(1 larynard)
$2.00 Quantity ________ Subtotal ________
Postage & Handling
(for all 3 items above)
$3.95 Quantity ________ Subtotal ________
      Total ___________
Please make the check payable to: Class of 1975 Reunion, and mail the check with this form to:
                        Jeanne Lavelle
			9703 Galsworth Court
			Fairfax, Virginia 22032