Breast Cancer Pink Ribbon Stained Glass Ornaments

ORDER FORM

Ship To:

Name:
Address:
City, State, Zip:
Phone # :
E-Mail (If available):
ITEM  #    PRICE        COST     
Ornament with Butterfly   $14.00 
Ornament without Butterfly  $12.00 
 Subtotal 
Single item  $3.00. More than one item  $5.00Shipping 
 TOTAL 


Mail completed form to:

MSDBC
c/o Charmayne Dierker, President
21710 Bayshore Road
Chestertown, Maryland 21620-4401
(410) 778-1982


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