2010 LWHS Calendar

 ORDER FORM FOR THE LWHS 2010 CALENDAR

_____ I WOULD LIKE TO ORDER ONE  “MEMBER’S” CALENDAR FOR $2.OO

(BE SURE YOUR MEMBERSHIP IS CURRENT FOR 2009)

(HOUSEHOLD MEMBERSHIPS ARE CONSIDERED AS A SINGLE MEMBER)

Check one:  ____Mail*     ___Local Delivery**    ___Pick-Up**

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LWHS MEMBER’S NAME                          STREET ADDRESS

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CITY                             STATE                          ZIP

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I WOULD LIKE TO ORDER ____  ADDITIONAL 2010 CALENDAR(S)  AT $4.00 EACH..

_____ CALENDAR(S)  ARE TO BE SENT  TO:

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NAME                                                STREET ADDRESS

CITY                                 STATE                        ZIP

I would prefer: ____Mail*   ____Local Delivery**   ___Pick-Up**

-USE AN ADDITIONAL SHEET TO ORDER ADDITIONAL CALENDARS-

*Add $2.00 postage for Each Calendar that is to be mailed.

**Members may save postage by asking for local delivery or by indicating on the order forms that they will “pick-up” their calendars at Gall’s Insurance Agency, Main Street, Lilly, Pa. – Mon. to Fri. – 9:00 am to 4:00 pm after November 22, 2008.

A Limited Number of 2003-04-05-06-07-08-09 LWHS Calendars are available-

To order, indicate by circling 2003-04-05-06-08-09 on the order form or order

the set of 2003 through 2009.  Add in the cost computation below:

PLEASE COMPUTE YOUR BILL:     (Price has tax  included)                      

            1       2010 LWHS Member Calendar                                          @ $2.00

                     ___     Additional 2010 LWHS Calendars                                     @ $4.00 each  -

                 ___    2003-04-05-06-07-08-09 LWHS Calendars                    @ $4.00 each

                    ___    Total Number of Calendars to be Mailed                             @ $1:50 each  -

                      ___   Set(s) 2003-04-05-06-07-08-09 LWHS Calendars         @ $15.00 a set -

               ___  Total Number of Sets to be mailed  @  $5.00 each -           $________

Please make check or money-order payable to L-WHS for  -

Send Orders to: L-WHS – c/o First National Bank of Lilly – Lilly, Pa. 15938