ORDER FORM

To: Jenny Brahney
1 - 3430 St. Anne Street
Port Coquitlam, BC
V3B 4G4 Canada
Your name....................................
Address.......................................
....................................................
................ ....................................
Tel.:..............................................
Your e-mail: ..................................
Date......................

"INDIAN SUMMER"

The numbers marked with 'P' are the most prominent signs on the plaque.
1. name...........................building #1

2. name...........................building #1
 
3. name...........................round sign on building #1
 
4. name.......P...................wagon (Farm-Produce)  

5. name...........................sign on building #5

6. name.......P...................top sign on building #6  

7. name...........................center sign on building #6

8. name...........................bottom sign on building #6

9. name...........................sign on building #9

10. name.......P..................billboard right top         

11. name.......P..................sign             

12. name.......P..................sign       

13. name.......P..................Restaurant     

14. name.......P..................for right carriage 

15. profession.. P................for right carriage   

16. name..........................flower wagon

17. name..........................barrel

Please include cheque or money-order for US$ 80.-. (Shipping and handling in Canada and the USA included)
Your picture will arrive within three weeks, ready for framing or laminating. Thank you.

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