Proud Lady Merchandise Order Form

You can order the following Proud Lady promotional items from AHBAI Headquarters. The price listed also includes postage and handling. Please mail check or money order (allow 3-4 weeks delivery) to:

Printout and return to:

AHBAI
401 N. Michigan Ave.
Suite 2200
Chicago, IL 60611



Quantity 					Amount Paid

_________	Duffle Bag ($18.00)		_____________

_________	Shampoo Cape ($7.00)		_____________



Total Items _________	 	Total Amt. Paid _____________


NAME: ___________________________________________________________

COMPANY: ________________________________________________________

ADDRESS: ________________________________________________________

CITY: ___________________________________________________________
 
STATE: __________________________________________________________

ZIP: ____________________________________________________________