CORN GOD STATUE ORDER FORM

********************************************************************

Corn god Statue ---------------------------------------$ 24.95

Federal Express ground Shipping--------------------$6.00

Packaging ---------------------------------------------------$1.50

********************************************************************

Sub Total ---------------------------------------------------$32.45

Sales Tax if you live in FL add 6% ( $1.95 )------

TOTAL ------------------------------------------------------

********************************************************************

Enclose PERSONAL Check or Money Order

Payable to SKELLY CONSTRUCTION CO.

*******************************************************************

PLEASE SEND A CORN GOD STATUE TO

*******************************************************************

Name : ------------------------------------------------------------------------------------------

Address: ----------------------------------------------------------------------------------------

City :-----------------------------------------------------------------------------------------------

State :----------------------------------------------Zip :-----------------------------------------

Phone :-------------------------------------------------------------------------------------------

***********************************************************************************

Please Mail Your Order to

********************************************************************

Skelly Construction Co.

P.O. Box 3305

Lantana, Florida 33465

Please print this

page from

your browser

NOTE : If you printer is

not working or a printer

is unavailable, you may

hand print your order on

a sheet of paper.

Thank You for Your Order

Your Business is Greatly Appreciated. - Ken

WE ACCEPT

PERSONAL CHECKS

MONEY ORDERS

BANK CASHIERS CKS