Ann Lepley

259 Elmcrest Ave.

Lakewood, N.Y. 14750

Please Print this form and mail it to me along with your payment.

Item

Quantity

Size

Color/Print

Price

         
         
         
         
         
         
         
         
         
         
         
Breed Of Dog :

  Subtotal

 
Neck Measurement :

Tax

 
Girth measurement (directly behind front legs):

Shipping**

 
Length (Base of neck to Base of tail):

TOTAL

 
Sex of Dog: Male Or Female (circle)



Price Range
**Shipping Cost
$0.01 - $9.99
$1.50
$10.00 - $15.00
$2.95
$15.01 - $30.00
$3.95
$30.01 - $70.00
$6.95
$70.01+
$10.50