LbNA White Decal Order Form
 (Printed on white background; colors shown are approximate.)
No minimum order!

Rectangular Decal: 8" x 2.5"
Square Decal : 3" x 3"
Rectangular White Decal (8" x 2.5"):
Quantity ________
x    $3.50 each
=   $_________
    
Square White Decal (3" x 3"):
Quantity ________
x    $2.25 each
=   $_________
  
  
TOTAL:                              $_________   
          Total due             
Mail to:

MoonLight Media
37 Parker Hill Road South
Higganum, CT 06441-4450

Ordered by:

Address:

City, State, Zipcode:

Phone:

_______________________________________

_______________________________________

_______________________________________

(_______)___________________

Please include one first-class stamp for every 4 decals,
plus a large self-addressed stamped envelope.