Pleasant Ridge Gift Shop Order Form

You may fill out this form on
your computer and then print
it out or you may print out
a blank form and fill it out
by hand.
Ship Order To:
Name:
Address #1:
Address #2
City, State, Zip Code
E-mail Address
Phone #
Item # Description Qty. Price
Each		 Total
Price


















































Mail this order form and your
check or money order to:

      Pleasant Ridge
      4567 Marshall Rd.
      Rantoul, Kansas 66079

 Subtotal:
KS Residents please add 6.4% tax:
Shipping:
Grand Total: