Name:
Chapter:
Street Address:
(No post office boxes!)
City, State, and Zip:
Day Phone:
Email:
Check enclosed for: $ for items.
**You will be billed at a later date for the most cost effective methods of shipping your purchases.
**Kentucky residents must add 6% sales tax.
**Make checks payable to: Dream Factory National Headquarters
Item
Qty/Size
Color
Cost Per Item
Total for Items
KY - 6% tax
Total
Total: $