ORDER FORM:
PLEASE PRINT AND FAX TO 860-823-1859

Qty:              Item Ordered:

________   WWL 101      both sides white
________   WL101          white, patterned
________   WL103          white, patriotic
________   WWL202       both sides white
________   WL202          white, patterned
________   WL203          white, patriotic
________   BBQ (1)        white, white
________   BBQ (2)        white, patterned
________   BBQ (3)        white, patriotic
________   WLM101       add .39 for magnet

Imprint Color: (Circle One):
Red   Burgundy   Blue   Green
Brown   Black   Teal   Orange

Binding Color: (Circle One):
Red   Burgundy   Blue   Green
Brown   Black   Teal   Orange

Billing Address:
Name:______________________
Street:______________________
City:________________________
State, Zip: ___________________
Phone: ______________________
Fax: ________________________
Visa/MC#: ___________________
Exp. Date:  ___________________
Name on Card:________________
Signature: ___________________

Shipping Address:
Name:________________________
Street:________________________
City: _________________________
State, Zip:____________________
Phone: _______________________

  Magi is the originator of the   Campaign Potholder. Magi   potholders carry the   candidate's message to his   constituents!

  Magi Potholders and Mitts are   completely quilted.

  For Logo Orders:
  Send Camera-Ready Artwork
  ($ 40.00 for plate/screen)

  For Line Copy Orders:
  Send exact copy of text as it   should appear on potholder.
  ($26.00 for lineage plate)

  Minimum Order: 250 Pieces
  Magi Potholder Orders Are   Shipped via FedEx