| Please mail the completed form
to: Chincoteague Natural History Association P.O. Box 917 Chincoteague, Va. 23336 Phone/Fax 757-336-3696 Call for additional shipping charge for multiple items or to use a credit card. "Celebrating Chincoteague National Wildlife Refuge" DVD |
|
| Mail To | |
| Name: | _________________________________________________ |
| Address: | _________________________________________________ |
| _________________________________________________ | |
| _________________________________________________ | |
| Phone Number: | _________________________________________________ |
| E-mail Address: | _________________________________________________ |
| Method of Payment | |
| Check/money Order: | _________________________________________________ |
|
Amount Enclsed: ($15.95 + $5.95 shipping) |
$ 21.90. |
| . |