Adoption Form


Please use this form to Adopt a Bear.

[FrontPage Save Results Component]
First Name
Last Name
Street Address
Address (cont.)
City
County (if NY)
State/Province
Zip/Postal Code
Country*
Email Address

I would like to purchase the following:

Bear Name
Payment

Payment Method

Purchase Amount  
Shipping* (please add $5.00 for shipping)  
NY Residents must add applicable sales tax  
Total Due  

* Please contact me for international shipping rates.

 


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Copyright 2000 From The Pinecone Woods
Last modified: November 28, 2002

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