Print and fill out this form then mail with your check or money order to: DeLange & Associates Marketing 2814 South Fremont Springfield, Missouri 65804 U.S.A. Ship To: Name:____________________________________ Street:____________________________________ City, State Zip:____________________________________             Your Phone: (_____)__________________________ No P.O. Boxes Please Except Check Money Orders DeLange & Associates Marketing 2814 S. Fremont Springfield, Missouri 65804 U.S.A. (417) 882-2214 For Large Quantities, Call Our Office.     DeLange & Associates Marketing 2814 S. Fremont Springfield, Missouri 65804 U.S.A. (417) 882-2214