Name:

Address: Home
P
h
o
n
e:
City State Cell
Zip Phone:

Email Address: Hostess Name

Hostess Phone
I would like to earn a $100 - $200+
shopping spree by hosting a party. ___Yes ___ Maybe ___Not
Now Order Deadline

I would like to earn a $100 - $200+

shopping spree by collecting orders. ___Yes ___ Maybe ___ Not Shipping/Handling
Now $4 minimum
Ship to Hostess: 10%
I would like to receive information Ship to Customer: 15%
about a Willow House business opportunity. ___Yes ___ Maybe ___ Not
Now All orders will be shipped in
2 to 3 weeks.

Qty Item No. Description Price Ea. Total

Method of Payment:
__ Check __ Cash
Please make your check
payable to Danielle
Holtzman.

50% off Customer special Visa MC Discover AmEx

50% off Customer special #____________________

Exp. Date _____/_____

Have you ordered Merchandise Total $____________

$39.96 or more? Shipping/Handling $____________ Signature

________________________________________________

Subtotal
For every $39.96 or more $____________
item you purchase, you can Customer Receipt
purchase another item that Sales Tax 7.3% $____________
Today’s Date _________
is $39.96 and under for Guest Total Due $____________
50% off! Amount Paid ______

Thank you for your order!

Visit my website and experience SIMPLY GOOD DESIGN!

Danielle Holtzman
(316) 259.6119 or danielleholtzman@cox.net
http://danielleholtzman.willowhouse.com