Order Form

Date:         ________________________

Name:        ________________________    

Address:    ________________________    

           City/State   ________________________   Zip ________

Phone:      ________________________

E-Mail:      ________________________

Hadley Family CD:          ($17.50 plus $2.50 Shipping = $20.00)

                                                                           Qty  ____     Cost ________

                                                                            Total _______

Please use the back of this page or attach a page telling us how you are related to the Hadley Family.

Please print this form, and send with your check or money order to:

Hadley Society
6042 Canterbury
Pittsboro, IN 46167

Please allow 2 to 3 weeks for delivery.  Thank you!