Nurses are Angels©  Mail In Order Form
All proceeds benefit the...
Christy Jones RN Scholarship
Scholarship Information and Application

Please print this Mail-In Order Form, complete all information and mail it to the address below.
Orders will be shipped within two days of receiving them. You can expect to receive your order
within 5 to 8 business days from the date it is received. Internatinal orders may require slightly longer.

ORDERED BY
Name_______________________________________________________________________________________
Street_______________________________________________________________________________________
City_________________________________________________________________________________________
State/Providence__________________________________Country______________________________________
Zip/Postal Code___________________________________Day Time Phone #_____________________________
Email Address ________________________________________________________________________________

ORDER HERE
Indicate quantity, extend price, add, P&H and total.
Qty  Item #  Description                   . $ Each  Amount
. .      

.
. .

.

.
Sub-total .

.
P&H .

.
Total .
...
POSTAGE & HANDLING
First Class U.S. Mail  ......  $3.50
Priority Mail (3-5 days) .... $5.00
 IMPORTANT:  Sorry ... we ship only within the United States.
 
...
PAYMENT METHOD
  ___Check ___ Money Order
.
Please make checks payable and send to:
Christy Jones Nursing Scholarship Fund
994 Antioch School Road
Vandalia, Ohio 45377 USA

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