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NAME:_____________________________________

ADDRESS:__________________________________

CITY______________________________________

STATE:____________________________________

ZIP CODE:__________PHONE:_________________

EMAIL ADDRESS:____________________________

MAKE ALL CHECKS OR MONEY ORDERS PAYABLE TO: GIANT ADS
(PLEASE DO NOT SEND CASH / CALL FOR C.O.D ORDERS)
SEND TO:

GIANT ADS
POST OFFICE BOX 4923
DAVENPORT, IOWA 52808
USA


CALL US AT: 1 (309)239-6300

ORDER ITEM/S: COST

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S/H= $6.50



TOTAL= $____________________

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