PEI B&B in Anne's Land, Prince Edward Island, Canada

Name:_________________________________________
Address:______________________________________
City: ________________________________________
prov/state:________Post/Zip Code:_____________
Telephone (          )_____________________

                       Loot Bags       $1.50
                      multiply x       _____  number of bags
                        subtotal      $_____
                               add     _____  10% sales tax
                             $4.95    $_____  add USA Postage
                             $3.95    $_____  add CDN Postage
                             Total    $_____

Select Payment method
Visa MC cheque
Personal Cheque: orders will be filled when check clears bank
Credit Card # ________________________________________ 

Name on Credit Card__________________________________

Signature of card holder________________________________
                               Date: _____________________________