SOLD TO:     Date:  

Address: 

City:        State:  Zip: 

Phone:   

Attn.:   

FAX #:   

E mail:  




 
SHIP TO:

Name:    

Address: 

City:        State:  Zip: 

Phone:   

FIGURINE			MINERAL



1. EAGLE		A. AMETHYST (purple)

2. UNICORN		B. PYRITE (gold)

3. DRAGON		C. DOLOMITE (white)

4. LOCOMOTIVE		D. AVENTURINE (green)	

5. ELEPHANT		E. SODALITE (blue)	

6. TIGER		F. CALCITE (orange)

7. RHINO		G. LEPIDOLITE (lilac)

8. CAT WITH BALL	H. CALCITE (white)	

9. HORSE		I. BORNITE (iridescent)

10. OWL			J. CALCITE (yellow)

11. OWL FAMILY		K. FLUORITE (blue)	

12. T-REX WITH TREE	L. CHRYSOCOLLA (green)		

13. ARMADILLO		M. AZURITE (blue)	

14. HIPPO		N. ROSE QUARTZ (pink)

15. BEAR		O. QUARTZ (clear)

16. MANATEE		P. CITRINE (brown)	

17. BEAR WITH FISH	Q. PYRITE (iridescent)		

18. DOLPHIN		R. POLISHED GRANITE (black)

19. ANCHOR			

COMBINATION-     QUANTITY-        

COMBINATION-     QUANTITY-   

COMBINATION-     QUANTITY-   

Total No. of items (this form):

*** Note: Total your items, multiply by $17.00 each, and make check or money order payable to:

MLR INC
P.O. Box 651
Worthington, OH 43085
USA

Phone: (800) 445-3465 ext. 12
or (614) 846-2026 (Central Ohio)

SPECIAL REQUESTS: (Ask us about popular motifs such as Southwestern Scenes; Railroading; Sports; Fantasy; etc.)