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| ITEM | PRICE | QUANTITY | SUB-TOTAL |
| Autism Awareness Bracelet | $ 5.00 | ||
| Car Magnet | $ 5.00 | ||
| Arbonne NutriMinC® RE9 System for Face, 6 Strip Sample Pack | $ 3.00 | ||
| SHIPPING & HANDLING | $ 5.95 |
1 |
$ 5.95 |
| TOTAL | |||
| Make Checks payable to: CIC-ASA | |||
| Ship to: | |||
| Central Indiana Chapter-ASA | |||
| P.O. Box 50534 | |||
| Indianapolis, IN 46250 | |||