Name of Party Ordering:
Address:
City:
Post Code:
Email:
Phone:	Best number to reach you.
Fax:
	Depending on current number of outstanding orders, please allow 2 to 3 weeks to complete your order.
Date Required:	All orders are 1st-come, 1st-served. For rush orders, an extra charge may apply.
	ORDER SECTION
Number of Memoirs Ordering at This Time:
Address #1
Town/City #1:	Estimated Date of Construction
Current Owner(s):
Date of Possession:	(i.e.month/year)
Previous Owner(s):  (if known)
Address #2
Town/City #2:	Estimated Date of Construction
Date of Possession:	(i.e.month/year)
Current Owner(s):
Previous Owner(s): (if known)
Address #3
Town/City #3:	Estimated Date of Construction
Current Owner(s):
Date of Possession:	(i.e.month/year)
Previous Owner(s): (if known)
	** DON'T PAY NOW - Payment Collected on Delivery **
Additional Instructions: