Mail Check to :

Gudaitis Services

278 East 208th Street

Euclid, OH 44123

Allow 2-3 weeks for delivery

Item being ordered_______________________________________________________

Name__________________________________________________________________

Street Address___________________________________________________________

Apartment or Suite Number (if applicable) ______________________________________

City___________________________________________________________________

State__________________________________________________________________

Zip Code_______________________________________________________________

Optional -

E Mail Address__________________________________________________

(will NOT be given out or sold to anyone - used for confirmation of orders, shipping confirmations and any correspondence that might be required on your order)

Last Updated 02/18/2000 by Gary Gudaitis