Order Form

Please Print this page.    Payment can be made in one of several ways: 

1. Return via postal service with check enclosed
2. Return via postal or fax with signed purchase order

Please make checks payable to: Friends of Californians with a Disability, Inc.

Mail to:
WINDMILLS
C/O Damon Brooks Associates
1601 Holly Avenue
Oxnard, CA 93036

Name _________________________________________________________________

Organization____________________________________________________________

Address _______________________________________________________________

Address 2 _____________________________________________________________

City, State, ZIP_________________________________________________________

Telephone Number_______________________________ Fax____________________

E mail Address _________________________________________________________

Amount Enclosed ____________________ P O Number ________________________