CHILDREN'S ROCKER ORDER PAGE

Name    First    Middle InitialLast

Address          

City                 

State                          Zip

Phone number  

E-Mail Address

Visa       Expiration Date

Master   Expiration Date

Amex     Expiration Date

Discover Expiration Date

#CF505 Child Rocker $41.00 Quantity         Color Shipping $18.00
#4007 Lyon Head Rocker $55.00 Quantity        Color Shipping $18.00
#4710 Open Weave Rocker $54.00 Quantity        Color Shipping $18.00
#4710 Open Weave Child's Chair $35.00 Quantity         Color Shipping $18.00
#4865 Solid Weave Rocker $47.00 Quantity         Color Shipping $18.00
#15/1139 "Harry" The Rocking Horse. $99.00 Quantity         Shipping $23.00
#588 Princess Kiddie Rocker $42.00 Quantity         Color Shipping $18.00
#748 Diamond Kiddie Rocker $42.00 Quantity         Color Shipping $18.00
#3001-INT. Child's Beaded Rocker $45.00 Quantity    Available in WHITE only. Shipping $18.00

COMMENTS & SPECIAL INSTRUCTIONS