Chawly Changer
Discount Order Page

To order, just:

 1.  Print the Order Form below, and fill it out.
If you don't have a printer, just calculate your cost, and write a note.

2.  Write a check or money order payable to:  
Chawly Products Co.

3.  Mail order and payment to:
Chawly Products Company
578  N. Laclede Station Rd.
St. Louis, MO  63119-2020

Discount  Order  Form

blue, green, purple, black, teal,
brown, smoke, 
==========\             or red  
    Quantity:          Color:      

Check
box  for
 keychain:

  $3.95 regular dispenser
 $4.45 with keychain
   (U. S. funds)    /======
  Price Ea:        Total:
         _____    ___________     [___]  _________  _________
         _____    ___________     [___]  _________  _________
         _____    ___________     [___]  _________  _________
         _____    ___________     [___]  _________  _________

******  U. S. currency only! ******

     Subtotal :  _________

       For deliveries in Missouri, add 7.575 % Sales Tax :

  _________

Deliveries to U. S. A. only

    Postage & Handling :  __2 . 0 5__
Send Chawly Changers to :              Grand Total :  _________
 name :  ___________________________________

 address :  _________________________________
 city / state / zip : ____________________________
 e-mail address :  ____________________________

Chawly Products Company is Charlie Wolters, the inventor of this unique product, and his machinery.  Any questions can be e-mailed to him at:
cpwolters@aol.com



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