Cindy Renfrow - A Sip Through Time

Please print out and mail this completed form, along with your check or money order, to:

Cindy Renfrow
7 El's Way
Sussex, NJ 07461
USA

PLEASE PRINT CLEARLY

SOLD TO:                                 SHIP TO: (If not the same)

___________________________________      ___________________________________
Name                                     Name

___________________________________      ___________________________________
Address                                  Address

___________________________________      ___________________________________
City, State, Zip                         City, State, Zip

___________________________________
Phone Number

___________________________________
email address

                                               |     |    P  R  I  C  E    |
| Item                                         | QTY |   Each    |  Total  |
|----------------------------------------------+-----+---------------------|
| A Sip Through Time                           |     |$18.00 U.S.|         |
|----------------------------------------------+-----+---------------------|
| Shipping*
-----------------------------------------------|-----|-----------|---------|
| Total 
-----------------------------------------------|-----|-----------|---------|

*Domestic postage is extra at $2.00 U.S. each.
International orders please email cindy at thousandeggs.com to determine shipping charges.

SHIPPING:

All U.S. and Canadian orders are sent via U.S. mail 4th class Book Rate.
Please allow 4 to 6 weeks for delivery.
Overseas orders are sent via U.S. surface mail. Faster delivery is available for an