Hologram Postcard Order Form

Frank DeFreitas
Box 85
Allentown, PA 18105

Please print your name and address to ship to below (please print clearly).

Name ____________________________________________________ 

Address __________________________________________________ 

City __________________________ State_____ ZIP _______________ 

Country ____________________________________________________

Email ____________________________________________________

Mark which item(s) you are ordering at this time:

_____Hologram Postcard(S) $4.99 (USA)

_____Hologram Postcard(S) $5.99 (CANADA)

_____Hologram Postcard(S) $6.99 (OVERSEAS)

PLEASE NOTE:
Check, Cash or Money Order in US FUNDS. Please make your check or money order
payable to Frank DeFreitas.