| Name: |
| Address: |
| City, State, Zip: |
| Phone # : |
| E-Mail (If available): |
| ITEM | # | PRICE |
COST |
| Support Handbook for Mothers | FREE | ||
| Support Handbook for Daughters | FREE | ||
| Breast Cancer Survivors' Club by Lillie Shockney |
$14.95 | ||
| Breast Cancer Awareness Art Work |
$15.00 | ||
| MSDBC Pin |
$10.00 | ||
| Stained Glass - 4" by 2" | $12.00 | ||
| MSDBC Logo Tote - 14-1/2" by 18-1/2" | $10.00 |
||
| Breast Cancer Awareness Blue Tote Bag - 14"by 13" | $20.00 |
||
| White Christmas Balls - six to a box |
$25.00 | ||
| White Christmas Balls - individual |
$5.00 | ||
| Large Flag - measures 28" by 40" |
$20.00 | ||
| Small flag - measures 8" by 12" |
$8.00 | ||
| Subtotal | |||
| Single item $3.00. More than one item $5.00 Handbooks no charge | Shipping | ||
| TOTAL | |||
| Mail completed form
to: MSDBC |