Name:
Phone Number:
Email Address:
Address:
Who do you want me to e-mail this form to (Name and e-mail):
The person I am sending this list to, is your:
List items desired (item# / description / price / quanity):
It would be OK to get a gift card for SU merchandise instead of the selected items (this way I can use it on an order through Claudia Perry): Yes
No
Additional Notes:

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