Please Print Clearly

ITEM #   x  
ITEM NAME      
ITEM #   x  
ITEM NAME      
ITEM #   x  
ITEM NAME      
ITEM #   x  
ITEM NAME      
Merchandise Sub-total
 
Kentucky residents Please add 6% sales tax
 
Add $2.00 for first item for Shipping and Handling
$1.00 for each additional item
 
Total Amount
 
Daytime Phone#
(required on all orders):
METHOD OF PAYMENT:
Enclose CHECK or MONEY ORDER
(Please do not send cash)
Todays Date
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Ship To:
Name: 
Address: 
Apt.#  
City________________________________State_______Zip

Mail order form and payment to:

Miles Osland
University of Kentucky
105 Fine Arts Building
Lexington, Kentucky 40506-0022

Thank You for your order.
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email: info@milesosland.com

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