Hinsdale Dayz
Order Form

Please print out this form, fill out and mail with payment to:

Hinsdale Dayz Committee
39 South Street
Hinsdale, MA  01235

Sorry, we are not set up to take credit cards.  Please pay by Check, Bank Check, Money Order, etc.  Please make payable to:

Hinsdale Dayz Committee

Please make checks for the Heritage Book payable to: H. & H. Book

Item

Price

Color

Qty.

Heritage of Hinsdale Book

$10 Each

Forever Green Ornament

$10 Each

 

Bicentennial Throw

$40 Each

 

TOTAL YOUR ORDER

 

Total Dollar Amount for your Order

Shipping and Handling
$4.25 first item, $1.50 ea. additional item

Total

 

 

 

 

CONTACT / SHIPPING (** required information)

 

**First Name

Middle Initial

**Last Name

**Street Address

**City

**State/Province

**Zip/Postal Code

**Country

Work Phone

Home Phone

**E-mail (used only in case of questions!)