EYE SHIELD
eye protection for dogs
ON-LINE ORDER FORM
PRICE ......................................... $ 5.00 ea.
S&H within the US ................ $ 5.00
S&H outside US.... please inquire
ORDER.
Eye Shield COLOR QUANTITY COST
MEASUREMENTS
SUBTOTAL
TAX
TOTAL
VA (US) only: 5%
Check or money Order made out to by Shari
Mail to S H Burghart
9137 Rockefeller Ln
Springfield, VA 22153
or via PayPal, account angelvest@cox.net
Shari Burghart
703-451-6480
I will send you an invoice/bill through PayPal. You may use that to charge your purchase or you may send a check to the address it gives.
EAR-TO-EAR (FRONT) AROUND HEAD UNDER CHIN
S&H
NAME
MAILING ADDRESS
PHONE
EMAIL
DOG'S NAME/BREED(S)
TELL ME ABOUT YOUR DOG
A
B
C
