Dixie Memories Order Form

Order Form
Pay by Check or Money Order only
We do not accept credit cards by choice. The expense is too large.

Print this form and fill in blanks by hand or save to file and open it in your word processor and fill in the blanks, enclose your payment and mail to the address below. Make checks payable to Chris Caudell

Dixie Memories
133 Rock View St.
Easley, SC 29640-1021

Quantity	Item description	Size	Price	Subtotal



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Write special instructions here.

(Purchaser information)

Name:

Address:

City/State/Zip code:

Phone number:

Email address:

Your email address to communicate about your order. I do not share your email address with anyone. My computer isn't infected because I use Linux instead of MS windows so my email program is never hyjacked.

(Shipping information) Complete only if it is different from the above address.

Name:

Shipping address:

City/State/Zip code: