FFCA Commemorative 2001 Order Form
~ For FFCA Members Only ~

Membership #
Name

Mailing Address
City
State/Province	Zip/Postal Code
Home Phone

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TO ORDER:   select from the following 

	For ONE Set	For TWO Sets
Order Single Wallpocket	Select Glaze 1 Bronze Green Terra Turquoise Old Ivory Gun Metal	Select Glaze 2 Bronze Green Terra Turquoise Old Ivory Gun Metal	Price $40 $80 $40/each
Order Set of 3 Wallpockets	Select Glaze 1 Bronze Green Terra Turquoise Old Ivory Gun Metal Select Glaze 2 Bronze Green Terra Turquoise Old Ivory Gun Metal Select Glaze 3 Bronze Green Terra Turquoise Old Ivory Gun Metal	Select Glaze 1 Bronze Green Terra Turquoise Old Ivory Gun Metal Select Glaze 2 Bronze Green Terra Turquoise Old Ivory Gun Metal Select Glaze 3 Bronze Green Terra Turquoise Old Ivory Gun Metal	Price $100 $200 $100/ 3 Set
Order Set of 4 Wallpockets	Select Glaze 1 Bronze Green Terra Turquoise Old Ivory Gun Metal Select Glaze 2 Bronze Green Terra Turquoise Old Ivory Gun Metal Select Glaze 3 Bronze Green Terra Turquoise Old Ivory Gun Metal Select Glaze 4 Bronze Green Terra Turquoise Old Ivory Gun Metal	Select Glaze 1 Bronze Green Terra Turquoise Old Ivory Gun Metal Select Glaze 2 Bronze Green Terra Turquoise Old Ivory Gun Metal   Select Glaze 3 Bronze Green Terra Turquoise Old Ivory Gun Metal   Select Glaze 4 Bronze Green Terra Turquoise Old Ivory Gun Metal	Price $130 $260 $130/ 4 Set
Will Pick up at Reunion 2001		PLEASE SHIP (after October 2001)

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Shipping/Handling	TOTAL
Up to $50 = $3.50	Shipping/Handling
$51 to $100 = $5.40	TOTAL DUE
$101 to $260 = $7.75

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Method of Payment	Method of Payment Check Money Order Cashier Check Charge to my VISA Charge to my MasterCard
Check Number	Card Number
Check Amount	Expiration
Signature

Complete form, print, and mail along with your check/money order to:

FFCA, PO Box 32571, Oklahoma City, OK 73123-0771

Make Check Payable to: FFCA