Name:

Address: Home
Phone:
City State Cell
Zip Phone:
Hostess Name
Email Address:
Hostess Phone
I would like to earn a $100 - $200+
shopping spree by hosting a party. ___Yes ___ Maybe ___Not Order Deadline
Now

I would like to earn a $100 - $200+

shopping spree by collecting orders. ___Yes ___ Maybe ___ Not
Now Shipping/Handling
$00.00 - $25.00 $6.00
I would like to receive information $25.01 - $50.00 $8.00
about a SLAH business opportunity. ___Yes ___ Maybe ___ Not $50.01 - $75.00 $10.00
Now $75.01 - $100.00 $12.00
$100.01+ 12% of Sales

All orders will be shipped to

Qty Item No. Description Price Ea. Total your hostess in 2 to 3 weeks.

Yes, I’d like to add a dollar or

more to help fight domestic
abuse.

Donation $_____

Customer special Method of Payment:

Customer special __ Check __ Cash
Please make your check
payable to _________.
Merchandise Total $____________

Shipping/Handling $____________ Visa MC Discover AmEx

#____________________
Subtotal Exp. Date _____/_____
$____________

Sales Tax 6.3% $____________

Guest Total Due $____________

Customer Receipt

Today’s Date _________

Amount Paid ______

Thank you for your order!

Have you ordered $29.95 OR MORE? Visit my website and explore the possibilities!
Don’t forget to take advantage of our monthly Danielle Holtzman
Customer Specials! (316) 613-2818 or danielleholtzman@cox.net
www.southernlivingathome.com/danielleholtzman