Date

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(Filling out this form does not automatically create an order. Use it for manually entering data only. You may print out this reservation form and mail it to us or fax it to: 804-739-2276.)

ITEM DESCRIPTION	Unit Price	Quantity	Shipping and Handling	VA Residents add 4.5% sales tax	TOTAL
Elvis Stained Glass Tableau	$99.50		$5.00
"Reminiscences of Robert E. Lee" Book	$145.00		$2.25
Sterling Silver Christmas Ornament	$37.00		$3.00
Renoir Umbrella Dolls	$1740.00		$12.00
Yeager Lithograph	$180.00		$10.00
1999 Christmas Plate	$135.00		$5.00
Art Glow Light	$25.00		$5.00
Double Eagle Statue Please attach name to be engraved	$2250.00		$50.00
Florence Nightingale 17" Doll	$135.00		$7.00