THE WIREGRASS COLLECTION ORDER FORM

To pay with a check or money order,
please print and complete the order form below and mail to:

J. Mack Dent
The Wiregrass Collection
1512 Birkdale Lane
Ponte Vedra Beach, Florida 32082

Note: Checks are subject to a 10 day waiting period
TITLE / ITEM
PRICE
QUANTITY
TOTALS

American Defenders Series
The Confederate Generals (16" x 20")
$115.00
x _______
= __________
The Confederate Generals (11.75" x 8.75 ")
$35.00
x _______
= __________
The Union Generals (16" x 20")
$115.00
x _______
= __________
The Union Generals (11.75" x 8.75 ")
$35.00
x _______
= __________
World War II Leaders (16" x 20")
$115.00
x _______
= __________
World War II Leaders (11.75" x 8.75 ")
$35.00
x _______
= __________

Coastal Plains Series
A South Georgia Home
$55.00
x _______
= __________
The South Georgia Football Team in 1929
$55.00
x _______
= __________
The South Georgia Football Team Offense in 1929
$55.00
x _______
= __________
The Sugar Cane Grinding
$55.00
x _______
= __________
South Georgia One-Room Schoolhouse in 1899
$55.00
x _______
= __________
Sigma Alpha Epsilon
True Gentlemen - The Founding Fathers of Sigma Alpha Epsilon (16" x 20" )
$115.00
x _______
= __________
True Gentlemen - The Founding Fathers of Sigma Alpha Epsilon (11.75" x 8.75 ")
$35.00
x _______
= __________
 
Shipping:
$25.00
Add 7% sales tax for Florida Residents
__________
 TOTAL:
__________
   
BILLING INFORMATION:  
Name:
 ____________________________________________
Address:
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City:
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State:
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Zip Code:
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Country:
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Phone:
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Email:
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SHIPPING INFORMATION:
Name:
 ____________________________________________
Address:
 ____________________________________________
City:
 ____________________________________________
State:
 ____________________________________________
Zip Code:
 ____________________________________________
Country:
 ____________________________________________
Phone:
 ____________________________________________
Email:
 ____________________________________________