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Early Quasquicentennial Crock Order Form

Make checks payable to: Early Quasquicentennial
Print this blank form, fill in, and mail with your check to:
Early Quasquicentennial C/O City of Early
PO Box 411
Early, IA 50535


I would like to order _________ crocks at $25.00 each = $_____________.

Check one: _____ I will be able to pick up my crock               (no s/h)

                  ______ Please mail the crock when in.
I'm enclosing $7.00 per crock for shipping/handling = $______________.
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Name: ______________________

Address: ____________________

City: _________________________ State ___________ Zip:_________

Phone: ___________________ Email (optional): __________________


                                                I'm enclosing a check for $_______________.

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