Name: __________________________

Address _________________________

        _________________________

Item 1 Description: ______________________   Size: _______ Qty:  ___  Price: $__________

Item 2 Description: ______________________   Size: _______ Qty:  ___  Price: $__________

Item 3 Description: ______________________   Size: _______ Qty:  ___  Price: $__________

Item 4 Description: ______________________   Size: _______ Qty:  ___  Price: $__________

Item 5 Description: ______________________   Size: _______ Qty:  ___  Price: $__________

Item 6 Description: ______________________   Size: _______ Qty:  ___  Price: $__________

Item 7 Description: ______________________   Size: _______ Qty:  ___  Price: $__________

Item 8 Description: ______________________   Size: _______ Qty:  ___  Price: $__________

Shipping: (If 6 items or less, add $3.00) (If more than 6 items add $0.00)             $__________

                                                                                                                              Total:  $__________
Please mail this form with your check or
money order made out to:

Magnetic Personalities

and mail to:

Jim Cannon
89 Curtis Street
Fulton, NY 13069
Mail In Order Form
Please print out form and  
mail as indicated below.

Thank You