Clip 6 Snap Ons
PO Box 263
500 W. Harriman Ave.
Bargersville, IN  46106
(317) 410-3692
(317) 422-1798
Email/Paypal: Clip6SnapOns@aol.com
Website: www.Clip6SnapOns.com
NAME:
STREET:
CITY, STATE,  ZIP
PHONE
EMAIL:
COMPLEXION
SHADE:
CHOOSE ONE:
PLEASE ALLOW 10 WORKING DAYS, 12 FOR UPPER AND LOWER..  FOR REPAIRS ONLY, PLEASE ALLOW 5 WORKING DAYS.
THIS EXCLUDES WEEKENDS AND HOLIDAYS.
** PLEASE send a Postal money order along with the impression made payable to Andy Patton**
Name:
Date:
By Typing Name & Date, You Agree To All Terms Listed On "Pricing" Page