SUMMER VALLEY EMBROIDERY                                                            ORDER FORM
R.D.#1 BOX 36A
NEW RINGGOLD, PA. 17960
TEL: ( 570 ) 386-3711   e-mail svemb@ptd.net

NAME________________________________________
ADDRESS_____________________________________
CITY_________________________________________
STATE____________ ZIP__________________
PHONE (      )__________ e-mail___________________		 SHIP TO ( IF OTHER THAN YOUR ADDRESS )
NAME_____________________________________
ADDRESS__________________________________
CITY______________________________________
STATE____________ZIP________________

ITEM #1

GARMENT__________________ SIZE_________
GARMENT COLOR___________ QUANTITY___
DESIGN #____________________________________
DESCRIPTION________________________________
                        PERSONALIZING LETTERING
ARCHED
ABOVE                                                                             
STRAIGHT BELOW                                                    
LETTERING COLOR_____________________

 GARMENT PRICE EACH     $__________
PERSONALIZING PRICE      $__________
DESIGN "B", "C' UPGRADE  $__________
                             TOTAL $__________
                      X QUANTITY    ________
               TOTAL ITEM # 1 $__________

ITEM #2

GARMENT__________________ SIZE________
GARMENT COLOR_____________ QUANTITY_____
DESIGN #_____________________________________
DESCRIPTION__________________________________
                        PERSONALIZING LETTERING
ARCHED
ABOVE                                                                                                
STRAIGHT BELOW_______________________
LETTERING COLOR___________________________

 GARMENT PRICE EACH        $__________
PERSONALIZING PRICE         $__________
DESIGN "B", "C" UPGRADE    $__________
                                     TOTAL  $__________
                            X QUANTITY   ________
                    TOTAL ITEM # 2  $__________

ITEM #3

GARMENT___________________ SIZE_________
GARMENT COLOR_______________ QUANTITY_____
DESIGN #____________________________________
DESCRIPTION________________________________
                       PERSONALIZING LETTERING
ARCHED
ABOVE                                                                            
STRAIGHT BELOW_______________________
LETTERING COLOR_______________________

 GARMENT PRICE EACH       $__________
PERSONALIZING PRICE       $__________
DESIGN "B", "C" UPGRADE   $__________
                                 TOTAL    $__________
                           X QUANTITY __________
                 TOTAL ITEM # 3   $__________
Make check or money order
payable in U.S. dollars to:
Summer Valley Embroidery		                                   TOTAL ITEMS #1, #2, #3 $__________
SHIPPING ( 10% of line above $5.00 minimum ) $__________
                                                 GRAND TOTAL $__________