EYE SHIELD
eye protection for dogs
PRINT'N'POST ORDER FORM
PRICE ........................................... $ 5.00 ea.
S&H within the US ....................... $5.00
S&H outside US.... please inquire
NAME
MAILING ADDRESS
PHONE EMAIL
DOG'S NAME / BREED(S)
MEASUREMENTS A = __________ B = __________ C = __________
EAR-TO-EAR AROUND HEAD UNDER CHIN
TELL ME ABOUT YOUR DOG
COLOR QUANTITY COST
$
$
Check or money Order made out to by Shari
Mail to S H Burghart SUBTOTAL $
9137 Rockefeller Ln SALES TAX > VA (US) only: 5% $
Springfield, VA 22153 S&H (US only) $ 5.00
or via PayPal, account angelvest@cox.net TOTAL $
Shari Burghart
703-451-6480
