Name: ______________________________________________________________

Address: ___________________________________________________________

____________________________________________________________________

Telephone: _________________________________________________________

Number of Books: ___________________

___ Member will pickup $20
___ Member - shipped $22
___ Non Member - shipped $25

Print and mail with payment to:

Conception Conti, VAE Commemorative Book, 1000 Cobb Hill Road, Waterbury, VT 05676

Print Order Form

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