Now accepting payment via PayPal Santa Fe Trail Doll Shop Phone 913-856-6757 18385 High View Dr E-mail ess532@kc.rr.com Gardner KS 66030-9603 ----------------------------------------------------------- Name------------------------------------------------------- Address---------------------------------------------------- City---------- State--------------- Zip:----- --- Phone.------------- ___________________________________________________________ Description Qty Total Price _________________________ ______ ____________ _________________________ ______ ____________ _________________________ ______ ____________ Sub Total ____________ Shipping ____________ Total ____________ Payment Method Check..Money Order..Credit Card. VISA, Master Card. Name on Card Please Print _______________________________________________________ Card Number ________________________ Exp Date_____/_____ Your Signature_________________________________________ Thank You For Your Order Jesse and Pat..

You may print this form and mail your payment..or we will call you for your credit card account, if you prefer. 10% of proceeds go to the Osteogenesis Imperfecta "Brittle Bones" Foundation. For Research..