Museum Shop Order Form

Ordered by:

Name: _____________________________

Street: _____________________________

City/State/Zip: _______________________

Telephone: ______________________
(In case of question)

 Shipped to (if different):

Name: _____________________________

Street: _____________________________

City/State/Zip: _______________________
QTY. TITLE OR ITEM UNIT PRICE TOTAL PRICE
       
       
       
       
       
   

SHIPPING

$ 4.00
   

TOTAL

  
Please send order form and check to:

Fifth Maine Regiment Museum
P. O. Box 41
Peaks Island, ME 04108

 Thank you for your order!