Holler Junction Souvenir Order Form

(Print this form out to your printer, fill it out and mail as indicated)

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                                                                Total

   Description & Color                          Quantity       $ Amount

       

 __________________________________________     ____________  __________



 __________________________________________     ____________  __________        



 __________________________________________     ____________  __________



           Shipping & Handling             Merchandise Total  __________ 

 $   0.00 - $  30.00 = $  3.50

 $  30.01 - $  60.00 = $  4.50           Shipping & Handling  __________

 $  60.01 - $  90.00 = $  5.50

 $  90.01 - $ 500.00 = $  6.50                         Total  __________

         



Name            ______________________________



Street Address  ____________________________________



City     _____________________________  



Province/State ______  ZIP/Postal Code __________



Day time telephone number __________________________



            Sorry! -- NO PHONE ORDERS    NO C.O.D.  



Please make your cheque or money order payable to LLOYD GWILLIAM 

in Canadian funds and mail to:



         Lloyd Gwilliam

         18 Sienna Ridge Landing SW

         Calgary, AB, Canada    

         T3H 3T1



(Please allow 4-6 weeks for delivery)



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Remember, if you didn't buy it at Holler Junction, you bought it

somewhere else!  THANK-YOU for ordering a Holler Junction product.