Printable Order Form

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  Name:_____________________________________________________________
  Street Address:___________________________________________
  _______________________________________________________
  City:______________________ State:_______  Zip:_____________
  Day Phone:____________________  Eve Phone:________________
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I would like to order the following

Quantity

Description

Price Each

Total

   

 

 
     

Indiana Residents Add 5% Sales Tax

 

Please Add $4.50 Shipping and Handling on all Orders inside the US

 

Total

 

 

Make check or money order payable to:

Rosaries For Our Lady

Mail check or money order and this form to:
Rosaries For Our Lady
4699 E. 266th St.
Arcadia, Indiana 46030
Please contact me either by phone or e-mail for shipping and handling rates outside US.

To Inquire about questions regarding your order please call:
(317) 984-5577

Thank You for Your Order

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